Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

Suguru Imaeda, MD


Actinic keratoses are common premalignant lesions that occur in fair-skinned individuals with high cumulative ultraviolet exposure. Monotherapy with ingenol mebutate has been known to cause local skin reactions, such as erythema, which reduces safety. Clobetasol propionate has worked well with other actinic keratosis therapies to reduce inflammation, but its role with ingenol mebutate is not well understood. The effect of concurrent application of clobetasol propionate with ingenol mebutate to reduce local skin reactions without impacting efficacy has not yet been investigated. We are proposing a superiority trial for safety as well as a non-inferiority trial for effectiveness. We will conduct an intra-individual, randomized controlled trial at the West Haven Veterans Affairs in patients with multiple actinic keratoses, and analyze local skin reactions at day 4 and efficacy at day 57. If combination therapy has significant advantages compared to monotherapy, it can improve the safety profile and tolerability of ingenol mebutate.

Open Access

This Article is Open Access