title: Ingenol Mebutate 500 µg on the Cheekbones with Concomitant Conjunctivitis.
abstract: Ingenol mebutate induces strong inflammation after a single application already. This must be taken into account when prescribing the drug, as mistakes in the application may results in severe side effects. Here, we report the case of a 72-year-old woman who applied ingenol mebutate on the cheekbones and developed a pronounced conjunctivitis, needing topical corticosteroids. The treatment was intended for the actinic keratosis she had on the chest, and the regimen of 2 consecutive once daily applications of ingenol mebutate at 500 µg/g had been prescribed as registered. The inadvertent application on the thin skin of the cheekbones led to a pronounced inflammation. With topical steroids followed by fusidic acid, both conjunctivitis and skin inflammation resolved within a few days. The skin showed erythema for a few weeks, but after 3 months, the patient presented a perfectly smooth skin and was very happy with the cosmetic outcome. This suggests that the cheekbones are a sensitive site for ingenol mebutate, but that intense inflammation should not scare physician or patient, as clinical remission with excellent healing can still be expected.
authors: Department of Dermatology and Venerology, CHUV, Lausanne, Switzerland.
authors: Olivier
authors: O
authors: Gaide
authors: Vincent
authors: V
authors: Cattin
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002610:Cheek; D003231:Conjunctivitis / Q000139:chemically induced* / Q000188:drug therapy; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004224:Diterpenes / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy*
chemical_list: C486592:3-ingenyl angelate; D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D003879:Dermatologic Agents; D004224:Diterpenes; D005938:Glucocorticoids