Severe local skin reaction after the application of ingenol mebutate gel treated by photodynamic therapy: A case report

  • Luca Negosanti S.Orsola-Malpighi University Hospital
  • Rossella Sgarzani Division of Plastic Surgery, S.Orsola-Malpighi University Hospital, Bologna, Italy.
  • Matteo Santoli Division of Plastic Surgery, Bellaria Hospital, Bologna, Italy.
  • Massimino Negosanti Division of Dermatology, S.Orsola-Malpighi University Hospital, Bologna, Italy
  • Nicoletta Banzola Division of Dermatology, S.Orsola-Malpighi University Hospital, Bologna, Italy
  • Francesca Negosanti Division of Dermatology, Centro Dermatologico Srl, Bologna, Italy.
Keywords: actinic keratosis, ingenol mebutate, photodynamic therapy


Ingenol mebutate (IM) was recently introduced for the treatment of actinic keratosis (AK). It is considered a safe and effective treatment in spite of local reactions frequently reported. These reactions may consist of erythema, flaking, crusting, swelling, vesicles and erosions, and would usually spontaneously recede within 20–30 days. We reported a case of a patient affected by multiple actinic keratosis of the scalp treated with IM. The patient reported a severe reaction that was not solved in two months. We decided to treat the reaction with photodynamic therapy and aminolevulinic acid. This treatment was demonstrated to be effective in solving this severe side effect.


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Case Reports