Treatment of Bowen’s Disease with Ingenol Mebutate: A Retrospective Study

Abstract

Management of BD is widely variable and there is little evidence for the most appropriate treatment. Our aim was to evaluate the effectiveness of ingenol mebutate (IM) gel in the treatment of patients with Bowen's disease (BD). We performed a retrospective analysis of 24 cases of biopsy-confirmed BD treated with IM. Data retrieved from the patients' file included age, sex, anatomic sites, clinical images of lesions, histopathological data of skin biopsies, local skin reactions, clinical and histological response to treatment, alternative treatments tried and follow-up. The majority of patients were females (18/24, 75%), with an average age of 79.5 years (range 53-90 years). Four of the 24 patients were lost to follow-up. The average duration of follow-up was 10.4 months (range 0.5-44 months). After treatment with IM, 41.7% of patients showed complete clinical resolution. Retreatment with IM of six non-responder patients led to three more cases of successful healing. Therefore, 54.2% of patients with BD lesions achieved complete resolution after treatment with one or two cycles of IM. Local skin reactions were mostly mild or moderate, and only 12.5% were regarded as severe. The results indicate that topical IM gel may be considered as a safe and beneficial non-invasive treatment option for BD, especially in patients who are poor candidates for surgery and anatomical sites that are unsuitable for other treatments. The acceptable safety profile, short treating course and easy self-application of IM gel may improve patient compliance.