FR -Aparición de herpes zoster secundario a la aplicación de ingenol mebutato en gel: comunicación del primer caso europeo

Abstract

An 85-year-old Caucasian man was referred to our clinic due to lesions clinically compatible with actinic keratoses (AKs), so one course of ingenol mebutate (IM) 0.015% gel was prescribed. One week after the treatment, the patient developed multiple painful vesicular lesions predominantly on the left half of the neck, compatible with a herpes zoster (HZ). Due to the location and clear temporal sequence, HZ was attributed to IM. Adverse skin reactions to IM include erythema, post-inflammatory hyperpigmentation and scarring, all due to local inflammation. Otherwise erosive pustular dermatosis of the scalp, bullous reaction and squamous cell carcinoma secondary to IM application have been described. No case of HZ related to IM has ever been reported before. In August 2015, based on the notification of 20 cases of HZ during the post marketing experience in USA, FDA included HZ as an adverse effect in the American prescribing information for IM. However, until now, this side effect has not been introduced in the European information. To our knowledge, we report the first European case of reactivation of the HZ caused by IM gel in an immunocompetent patient.