Actinic keratoses (AK) are common cutaneous lesions associate with chronic ultraviolet
radiation exposure. While most authorities consider AK as a pre-malignant lesion, some
consider it as an incipient squamous cell carcinoma (SCC). Ingenol mebutate is the active
compound in the sap from Euphorbia peplus L. (E. peplus). Topical ingenol mebutate treatment
has been approved for the treatment of AKs. Ingenol mebutate gel 0.015% has shown to not only
have a high clearance rate but also a transient localized inflammatory skin response that
resolves quickly without sequelae. However, these localized skin responses (eg erythema,
erosion/ulceration, edema, etc.) can often be unpleasant and unsightly. Currently, there are
no clinical studies evaluating combination therapies (eg topical steroids, emollients) with
ingenol mebutate 0.015% that would decrease irritation and improve wound healing while
maintaining efficacy.