Jim On Shelbi C, Hashim Peter W, Nia John K, Lebwohl Mark G
J Drugs Dermatol. 2017 May 1;16(5):432-436.
Background: Ingenol mebutate gel 0.015% provides high clearance rates for actinic keratosis (AK) on the face and scalp but causes transient local skin responses (LSRs).
Objective: This study sought to determine whether the application of 1% dimethicone would decrease ingenol mebutate-associated LSRs and/or affect efficacy during the treatment of multiple AKs on the face.
Methods: Ingenol mebutate gel 0.015% was applied for 3 days to two 25 cm2 areas, each containing 3 to 8 AKs on the face of each subject, followed by application of 1% dimethicone lotion in an investigator-blinded manner to one randomly selected AK-containing area until LSRs were no longer present.
Results: In total, 20 subjects were enrolled and completed the study. Topical 1% dimethicone lotion applied during and after treatment of facial AK with ingenol mebutate gel 0.015% reduced mean total LSR scores at days 8 and 15 compared with ingenol mebutate gel only, although the difference was not statistically significant. Efficacy was equivalent between the two treatment arms.
Limitations: The study evaluated a relatively small number of subjects, all of whom were white.
Conclusions: The application of 1% dimethicone following ingenol mebutate gel 0.015% produced a trend toward lower severity of some LSRs, with no difference in efficacy.
J Drugs Dermatol. 2017;16(5):432-436.
.0.015%的斑蝥素乳膏对面部和头皮的光化性角化病（AK）具有较高的清除率，但会引起短暂的局部皮肤反应（LSR）。
本研究旨在确定1%二甲基硅油的应用是否会减少斑蝥素相关的LSR，并/或影响面部多个AK治疗期间的疗效。
在每位受试者面部的两个25平方厘米区域，每个区域包含3至8个AK，涂抹0.015%的斑蝥素乳膏3天，然后以研究者盲法的方式在一个随机选择的含AK区域涂抹1%二甲基硅油洗剂，直至LSR不再出现。
共有20名受试者入组并完成研究。与仅使用斑蝥素乳膏相比，在使用0.015%斑蝥素乳膏治疗面部AK期间及之后涂抹1%二甲基硅油洗剂，在第8天和第15天的平均总LSR评分降低，尽管差异无统计学意义。两个治疗组的疗效相当。
该研究评估的受试者数量相对较少，且均为白人。
在0.015%斑蝥素乳膏之后应用1%二甲基硅油有使某些LSR严重程度降低的趋势，疗效无差异。
《药物皮肤病学杂志》2017年；16(5):432 - 436。
