Two cases of SCC described after ingenol mebutate gel application

(HealthDay)—Two cases of squamous cell carcinoma (SCC) have been described, with rapid onset after application of ingenol mebutate gel for treatment of actinic keratosis (AK). The report was published online July 31 in the British Journal of Dermatology.

Juan Antonio Moreno Romero, M.D., from the Quirónsalud Hospital General de Catalunya in Barcelona, Spain, and colleagues describe two cases of SCC with rapid onset after ingenol mebutate gel application for the treatment of AKs.

The first case involved a 95-year-old woman who presented with an erythematous, flat, rough lesion on the forehead. She was treated for a clinical diagnosis of AK with 0.015 percent ingenol mebutate for three days. Four weeks later, a painful tumor had developed over the previous lesion; tumoral growth started in the first two weeks after treatment. A 15-mm crateriform nodule with a keratotic core was observed. The second case was a 78-year-old woman who consulted for multiple AKs on the neck base. She was prescribed 0.015 percent ingenol mebutate gel. The patient presented with an ulcerated tumor of about 14 mm diameter in the same anatomical location five weeks later. Tumoral growth started about two weeks after treatment application. After surgical excision, histological examination revealed a well-differentiated SCC.

"We believe that dermatologists should be alert to the possible emergence of new cases of SCCs after treatment with ingenol mebutate," the authors write.

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