title: Efficacy of ingenol mebutate gel for actinic keratosis in patients treated by thiazide diuretics.
abstract: Actinic keratosis (AK) is considered as superficial squamous cell carcinoma. Chronic sun exposure plays a central role in its pathogenesis. In particular, ultraviolet B radiation causes direct damage to the DNA, producing pyrimidine dimers that suppress the protective role of p53. Other risk factors include advanced age, male sex, and fair skin type. Even some drugs used for treating blood hypertension, such as thiazide diuretics, can increase the risk of developing AK. Their photosensitizing action seems to be connected with reactive oxygen species production. We report our experience with ten patients affected by multiple AK, in therapy with thiazide diuretics, treated by ingenol mebutate gel. AK was clinically and dermoscopically evaluated at baseline and after 30 days from the beginning of the treatment. Moreover, patients were screened for vitamin D3values and reported a general hypovitaminosis status. To our knowledge, we report for the first time the efficacy of ingenol mebutate gel in this group of patients, particularly at risk of developing AK.
authors.affiliation: Department of Dermatology.
authors.forename: Elena
authors.initials: E
authors.lastname: Campione
authors.affiliation: Department of Dermatology.
authors.forename: Monia
authors.initials: M
authors.lastname: Di Prete
authors.affiliation: Department of Dermatology.
authors.forename: Laura
authors.initials: L
authors.lastname: Diluvio
authors.affiliation: Department of Dermatology.
authors.forename: Luca
authors.initials: L
authors.lastname: Bianchi
authors.affiliation: Department of Pathology, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Orlandi
keywords: anticancer agents; antitumor activity; cancer cells; skin precancerous lesion