Speed Abating of Pre-Cancerous Condition

Actinic keratosis quickly treated with Picato

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) It's not skin cancer, but actinic keratosis (AK) is a condition that's headed in that direction. It can show up as one red, scaly spot or a number of lesions. And while there are a number of ways to treat AK, there are limitations, and a new prescription medication speeds up the process.

A Phase III clinical trial has shown that a recently approved topical medication - Picato (ingenol mebutate) - significantly decreases the time needed to effectively treat multiple actinic keratosis lesions. 

"Wear sunscreen every day."

AK tends to develop in people with fair skin who are prone to sunburns. If left untreated, AK can lead to the second most common type of skin cancer, squamous-cell carcinoma, which is related to sun exposure.

When there's only one spot, the most common treatment is cryosurgery that freezes off the lesion. This method doesn't work with multiple lesions, and that's where topical medications come in.

Current AK medications take weeks or months to clear up lesions. In the process, the skin gets irritated and inflamed to the point that many patients abandon the treatment.

A multi-center trial testing Picato was led by Mount Sinai School of Medicine researchers and published in the March 15, 2012 issue of the The New England Journal of Medicine. 

Researchers worked with two groups of people - 547 patients who had actinic keratoses on the face or scalp and 458 individuals with AK on the trunk or extremities. Half of each group was given either the Picato or a placebo.

The group of patients who had facial and scalp AK applied a .015 percent concentration for three days, and the other group used a 0.05 percent concentration for two days. 

In the first group, 42 percent of the people saw a complete clearance of AK. In the second group, 34 percent saw AK go away after two days. This compares to 4-5 percent of people in the placebo groups who saw results.

Mark Lebwohl, M.D., lead study author and professor and chair of the Department of Dermatology at Mount Sinai School of Medicine, said "The shorter period is a more effective option for patients who don’t want a treatment that interferes with their everyday lives for weeks or even months.”

Picato was approved by the U.S. Food and Drug Administation (FDA) in late January, 2012 and costs about $700 for three applications.

Dr. Lebwohl is currently a paid consultant for Leo Pharmaceuticals (LEO), but did not have any financial interests in LEO during the period this study was active. The company funded this research. 

Reviewed by: 
Review Date: 
March 26, 2012
Last Updated:
March 27, 2012