<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02990221</url>
  </required_header>
  <id_info>
    <org_study_id>IIS-PICATO 1264</org_study_id>
    <nct_id>NCT02990221</nct_id>
  </id_info>
  <brief_title>Efficacy of Ingenol Mebutate on Actinic Keratoses and Field Cancerization vs Cryotherapy</brief_title>
  <official_title>A Randomized Study to Evaluate the Efficacy of Ingenol Mebutate on Actinic Keratoses and Field Cancerization Compared to Cryotherapy</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of Campania &quot;Luigi Vanvitelli&quot;</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>University of Campania &quot;Luigi Vanvitelli&quot;</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
    <is_us_export>No</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      The main objective of this study is to compare the effectiveness of ingenol mebutate gel (150&#xD;
      mcg / g per day, to be applied on a predetermined area of 25 cm2 of skin of the face or&#xD;
      scalp, for 3 days consecutive) cryotherapy (application with 5 seconds of freezing time of&#xD;
      each lesion located in a predetermined skin area of 25 cm2 of the face or scalp) in the&#xD;
      treatment of actinic keratosis and their field cancerization.&#xD;
&#xD;
      Study details:&#xD;
&#xD;
      This study is randomized. 50 subjects with at least two actinic keratoses of grade I and II,&#xD;
      located in two different districts of 25 cm2 skin of the face or scalp, and who meet all the&#xD;
      inclusion criteria will be enrolled in the study by the investigators in the three different&#xD;
      centers mentioned above.&#xD;
&#xD;
      The investigators will assess the effect of treatment by confocal microscopy and digital&#xD;
      dermoscopy. The investigator will acquire images of selected areas of the face and scalp&#xD;
      before and after treatment. Data will be collected and analyzed by the coordinating centre.&#xD;
&#xD;
      Procedure for the study:&#xD;
&#xD;
      Recruitment of subjects; random assignment of treatment (ingenol mebutate gel 150&#xD;
      micrograms/g and cryotherapy) to the two skin areas of 25 cm2 of the subject recruited;&#xD;
      evaluation of the two areas with reflectance confocal microscopy and digital dermoscope. The&#xD;
      measurements will be carried out at time 0, after 1 month and 6 months. The investigator must&#xD;
      fill out a form for each subject at the beginning (day 0), after 1 month and at the end of&#xD;
      the study (after 6 months). The subject must complete a questionnaire at the beginning (day&#xD;
      0), after 1 month and at the last follow-up visit (after 6 months).&#xD;
&#xD;
      Measurement parameters: Dermoscopy and confocal microscopy will be used to assess the&#xD;
      percentage reduction in actinic keratoses and the damage of the cancerous area in the two&#xD;
      selected areas treated with ingenol mebutate gel or cryotherapy, respectively.&#xD;
&#xD;
      Adverse / side events will be collected at each visit by the investigator and will be&#xD;
      contained in another form.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      This study is designed to compare the efficacy of topical ingenol mebutate (150 mcg/g once&#xD;
      daily on a selected facial or scalp target area of 25 cm2, for 3 consecutive days) with&#xD;
      cryosurgery (applied for a freeze time of 5 seconds, on each lesion included in an area of 25&#xD;
      cm2 on face or scalp)&#xD;
&#xD;
      This is a national, post-marketing (phase 4), on label, interventional, randomized trial.&#xD;
&#xD;
      Subjects will attend a screening visit where they will be assessed for eligibility.&#xD;
&#xD;
      Two areas of treatment in the same patient have to be identified (e.g. scalp and cheek or two&#xD;
      different part of the balding scalp), than these two areas will be randomized in a 2:1 ratio:&#xD;
      one will be treated with cryosurgery and the other one with Picato Gel.&#xD;
&#xD;
      The cryosurgery will be performed in the same day during the visit (1 application for a&#xD;
      freeze time of 5 seconds, on each lesion included in an area of 25 cm2 on face or scalp)&#xD;
      Picato gel 150 mcg will be applied at home by the patient, according to current indication&#xD;
      (RCP: 3 consecutive days for a total of three application in an area of 25 cm2) Subjects will&#xD;
      be followed for 24 weeks (about 6 months) after the cryosurgery application (Visit 1).&#xD;
&#xD;
      Adverse events and patient compliance will be recorded 7 days after cryosurgery application&#xD;
      and 5 days after first Picato gel application (Visit 2). The number of AKs present within the&#xD;
      treatment areas will be counted at Visit 1 (Baseline AK count) and at Visits 3 - 4 (AKcount).&#xD;
      The data obtained will provide information on the effect of Picato gel versus Cryosurgery on&#xD;
      recurrence rate of AKs.&#xD;
&#xD;
      Furthermore, the trial will also provide data on the effect of Picato gel versus Cryosurgery&#xD;
      on the appearance rate of new AKs.&#xD;
&#xD;
      The final results for all subjects will be included in a Final Clinical Study Report in the&#xD;
      original submission. This includes final results for all primary and secondary endpoints as&#xD;
      well as 6-month recurrence and Adverse Event data.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">April 12, 2017</start_date>
  <completion_date type="Actual">July 30, 2018</completion_date>
  <primary_completion_date type="Actual">April 30, 2018</primary_completion_date>
  <phase>Phase 4</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>At least 75% reduction in the total AK count relative to baseline</measure>
    <time_frame>6-month follow-up</time_frame>
    <description>The primary efficacy endpoint is the percentage change, at the end of the treatment period, in the number of AK lesions that were originally defined in the selected AK target area at baseline. The percentage change in the number of AK lesions is calculated as the number of lesions present at the end of the treatment period in the target area minus the number of AK lesions present in the target area at baseline visit divided by the number of lesions present in the target area at baseline. This variable will be analysed using a non-parametric analysis (Wilcoxon Rank-sum test).</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Reduction of subclinical AK lesions according to a Reflectance Confocal Microscopy score</measure>
    <time_frame>6-month follow-up</time_frame>
    <description>Change from baseline in RCM score of target area and RCM score of cancerization field at the end of the treatment period. Each of the 13 RCM criteria will be scored 0 (absent), 1 (&lt;25%), 2 (25%-50%), 3 (50-75%), or 4(&gt;75%). An overall score will be obtained by averaging the RCM scores at the epidermal, DEJ and dermal level. The same approach will be used for the RCM examination of the cancerization field. The above variables will be compared between the groups using a t-test, 95% confidence interval for the between-group difference will be provided.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Absence of new lesions after a follow-up period of 6 months</measure>
    <time_frame>6-month follow-up</time_frame>
    <description>The count of AK lesions will be performed by exploration and palpation (numeric count) and the presence will be also confirmed by dermoscopic assessment (numeric count)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>cosmetic outcome</measure>
    <time_frame>6-month follow-up</time_frame>
    <description>cosmetic outcome will be evaluated by Patient's assessment of satisfaction to product at the end of the treatment period (specific questionnaire)</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">50</enrollment>
  <condition>Actinic Keratosis</condition>
  <arm_group>
    <arm_group_label>Ingenol mebutate</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>application of ingenol mebutate for 3 consecutive days on an area of face/scalp of 25 cm2</description>
  </arm_group>
  <arm_group>
    <arm_group_label>cryotherapy</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>application of criotherapy on actinic keratosis present in an area of face/scalp of 25 cm2 different from the ingenol mebutate area</description>
  </arm_group>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Ingenol mebutate</intervention_name>
    <description>150 mcg / g per day, to be applied on a predetermined area of 25 cm2 of skin of the face or scalp, for 3 days consecutive</description>
    <arm_group_label>Ingenol mebutate</arm_group_label>
    <other_name>Picato</other_name>
  </intervention>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>cryotherapy</intervention_name>
    <description>application with 5 seconds of freezing time of each lesion located in a predetermined skin area of 25 cm2 of the face or scalp</description>
    <arm_group_label>cryotherapy</arm_group_label>
    <other_name>cryosurgery</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        A patient will be enrolled if he/she meets all of the following inclusion criteria:&#xD;
&#xD;
          -  Current diagnosis of AK, with ≥2 lesions of grade I and/or II located in two different&#xD;
             anatomical districts (within a contiguous 25 cm2 area on the face, scalp or forehead);&#xD;
&#xD;
          -  Male ≥ 18 years of age or Female &gt; 60 years of age;&#xD;
&#xD;
          -  Skin type I or II according to Fitzpatrick;&#xD;
&#xD;
          -  Patient has confirmed his/her willingness to participate in this study after being&#xD;
             informed of all aspects of the study that are relevant to his/her decision to&#xD;
             participate, by signing and dating the approved informed consent form, according to&#xD;
             ICH and local laws.&#xD;
&#xD;
        The 25 cm2 contiguous treatment areas could be of any shape, e.g. 5 cm x 5 cm, 2 cm x 12.5&#xD;
        cm, 3 cm x 8.3 cm.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        A patient will be excluded if he/she meets any of the following exclusion criteria:&#xD;
&#xD;
          -  Has received any therapy for AK within the past 3 months&#xD;
&#xD;
          -  Has AK of grade III&#xD;
&#xD;
          -  Has currently a skin cancer or shows an early stage of skin cancer;&#xD;
&#xD;
          -  Has another skin disease that requires treatment with other medications in the AK area&#xD;
             or in distance of 3 cm;&#xD;
&#xD;
          -  Use of cosmetic or therapeutic products and procedures which could interfere with&#xD;
             assessments of the treatment area;&#xD;
&#xD;
          -  Immunosuppressive therapies or current treatment for cancer;&#xD;
&#xD;
          -  Clinically unstable medical condition;&#xD;
&#xD;
          -  High risk group for HIV infection or presentation of other infectious diseases&#xD;
             (hepatitis A virus , hepatitis B virus , hepatitis C virus , Tuberculosis, etc);&#xD;
&#xD;
          -  Allergies to the tested gel (ingenol mebutate and eccipients);&#xD;
&#xD;
          -  Pregnancy and breastfeeding (see inclusion criteria);&#xD;
&#xD;
          -  Psychiatric disease that may interfere with follow-up of study procedures;&#xD;
&#xD;
          -  Participation in other clinical trials up to 30 days prior to day 1 of the study;&#xD;
&#xD;
          -  Patient is, for any reason, considered by the investigator to be an unsuitable&#xD;
             candidate for the study.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Giuseppe Argenziano, Prof</last_name>
    <role>Principal Investigator</role>
    <affiliation>University of Campania &quot;Luigi Vanvitelli&quot;</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Second University of Naples</name>
      <address>
        <city>Naples</city>
        <zip>80131</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Italy</country>
  </location_countries>
  <results_reference>
    <citation>Frost CA, Green AC. Epidemiology of solar keratoses. Br J Dermatol. 1994 Oct;131(4):455-64. doi: 10.1111/j.1365-2133.1994.tb08544.x.</citation>
    <PMID>7947197</PMID>
  </results_reference>
  <results_reference>
    <citation>Fu W, Cockerell CJ. The actinic (solar) keratosis: a 21st-century perspective. Arch Dermatol. 2003 Jan;139(1):66-70. doi: 10.1001/archderm.139.1.66. No abstract available.</citation>
    <PMID>12533168</PMID>
  </results_reference>
  <results_reference>
    <citation>Ortonne JP. From actinic keratosis to squamous cell carcinoma. Br J Dermatol. 2002 Apr;146 Suppl 61:20-3. doi: 10.1046/j.1365-2133.146.s61.6.x.</citation>
    <PMID>11966728</PMID>
  </results_reference>
  <results_reference>
    <citation>Cohen JL. Actinic keratosis treatment as a key component of preventive strategies for nonmelanoma skin cancer. J Clin Aesthet Dermatol. 2010 Jun;3(6):39-44.</citation>
    <PMID>20725550</PMID>
  </results_reference>
  <results_reference>
    <citation>Padilla RS, Sebastian S, Jiang Z, Nindl I, Larson R. Gene expression patterns of normal human skin, actinic keratosis, and squamous cell carcinoma: a spectrum of disease progression. Arch Dermatol. 2010 Mar;146(3):288-93. doi: 10.1001/archdermatol.2009.378.</citation>
    <PMID>20231500</PMID>
  </results_reference>
  <results_reference>
    <citation>Vatve M, Ortonne JP, Birch-Machin MA, Gupta G. Management of field change in actinic keratosis. Br J Dermatol. 2007 Dec;157 Suppl 2:21-4. doi: 10.1111/j.1365-2133.2007.08268.x.</citation>
    <PMID>18067627</PMID>
  </results_reference>
  <results_reference>
    <citation>Fidler B, Goldberg T. Ingenol mebutate gel (picato): a novel agent for the treatment of actinic keratoses. P T. 2014 Jan;39(1):40-6.</citation>
    <PMID>24672213</PMID>
  </results_reference>
  <results_reference>
    <citation>Andrews MD. Cryosurgery for common skin conditions. Am Fam Physician. 2004 May 15;69(10):2365-72.</citation>
    <PMID>15168956</PMID>
  </results_reference>
  <verification_date>September 2019</verification_date>
  <study_first_submitted>December 2, 2016</study_first_submitted>
  <study_first_submitted_qc>December 8, 2016</study_first_submitted_qc>
  <study_first_posted type="Estimate">December 13, 2016</study_first_posted>
  <last_update_submitted>September 23, 2019</last_update_submitted>
  <last_update_submitted_qc>September 23, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">September 24, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>University of Campania &quot;Luigi Vanvitelli&quot;</investigator_affiliation>
    <investigator_full_name>Giuseppe Argenziano</investigator_full_name>
    <investigator_title>Professor</investigator_title>
  </responsible_party>
  <keyword>Field Cancerization</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Keratosis, Actinic</mesh_term>
    <mesh_term>Keratosis</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02990221
org study id: IIS-PICATO 1264
nct id: NCT02990221
lead sponsor: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
is us export: No
The main objective of this study is to compare the effectiveness of ingenol mebutate gel (150
      mcg / g per day, to be applied on a predetermined area of 25 cm2 of skin of the face or
      scalp, for 3 days consecutive) cryotherapy (application with 5 seconds of freezing time of
      each lesion located in a predetermined skin area of 25 cm2 of the face or scalp) in the
      treatment of actinic keratosis and their field cancerization.

      Study details:

      This study is randomized. 50 subjects with at least two actinic keratoses of grade I and II,
      located in two different districts of 25 cm2 skin of the face or scalp, and who meet all the
      inclusion criteria will be enrolled in the study by the investigators in the three different
      centers mentioned above.

      The investigators will assess the effect of treatment by confocal microscopy and digital
      dermoscopy. The investigator will acquire images of selected areas of the face and scalp
      before and after treatment. Data will be collected and analyzed by the coordinating centre.

      Procedure for the study:

      Recruitment of subjects; random assignment of treatment (ingenol mebutate gel 150
      micrograms/g and cryotherapy) to the two skin areas of 25 cm2 of the subject recruited;
      evaluation of the two areas with reflectance confocal microscopy and digital dermoscope. The
      measurements will be carried out at time 0, after 1 month and 6 months. The investigator must
      fill out a form for each subject at the beginning (day 0), after 1 month and at the end of
      the study (after 6 months). The subject must complete a questionnaire at the beginning (day
      0), after 1 month and at the last follow-up visit (after 6 months).

      Measurement parameters: Dermoscopy and confocal microscopy will be used to assess the
      percentage reduction in actinic keratoses and the damage of the cancerous area in the two
      selected areas treated with ingenol mebutate gel or cryotherapy, respectively.

      Adverse / side events will be collected at each visit by the investigator and will be
      contained in another form.
This study is designed to compare the efficacy of topical ingenol mebutate (150 mcg/g once
      daily on a selected facial or scalp target area of 25 cm2, for 3 consecutive days) with
      cryosurgery (applied for a freeze time of 5 seconds, on each lesion included in an area of 25
      cm2 on face or scalp)

      This is a national, post-marketing (phase 4), on label, interventional, randomized trial.

      Subjects will attend a screening visit where they will be assessed for eligibility.

      Two areas of treatment in the same patient have to be identified (e.g. scalp and cheek or two
      different part of the balding scalp), than these two areas will be randomized in a 2:1 ratio:
      one will be treated with cryosurgery and the other one with Picato Gel.

      The cryosurgery will be performed in the same day during the visit (1 application for a
      freeze time of 5 seconds, on each lesion included in an area of 25 cm2 on face or scalp)
      Picato gel 150 mcg will be applied at home by the patient, according to current indication
      (RCP: 3 consecutive days for a total of three application in an area of 25 cm2) Subjects will
      be followed for 24 weeks (about 6 months) after the cryosurgery application (Visit 1).

      Adverse events and patient compliance will be recorded 7 days after cryosurgery application
      and 5 days after first Picato gel application (Visit 2). The number of AKs present within the
      treatment areas will be counted at Visit 1 (Baseline AK count) and at Visits 3 - 4 (AKcount).
      The data obtained will provide information on the effect of Picato gel versus Cryosurgery on
      recurrence rate of AKs.

      Furthermore, the trial will also provide data on the effect of Picato gel versus Cryosurgery
      on the appearance rate of new AKs.

      The final results for all subjects will be included in a Final Clinical Study Report in the
      original submission. This includes final results for all primary and secondary endpoints as
      well as 6-month recurrence and Adverse Event data.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: None (Open Label)
measure: At least 75% reduction in the total AK count relative to baseline
time frame: 6-month follow-up
description: The primary efficacy endpoint is the percentage change, at the end of the treatment period, in the number of AK lesions that were originally defined in the selected AK target area at baseline. The percentage change in the number of AK lesions is calculated as the number of lesions present at the end of the treatment period in the target area minus the number of AK lesions present in the target area at baseline visit divided by the number of lesions present in the target area at baseline. This variable will be analysed using a non-parametric analysis (Wilcoxon Rank-sum test).
measure: Reduction of subclinical AK lesions according to a Reflectance Confocal Microscopy score
time frame: 6-month follow-up
description: Change from baseline in RCM score of target area and RCM score of cancerization field at the end of the treatment period. Each of the 13 RCM criteria will be scored 0 (absent), 1 (<25%), 2 (25%-50%), 3 (50-75%), or 4(>75%). An overall score will be obtained by averaging the RCM scores at the epidermal, DEJ and dermal level. The same approach will be used for the RCM examination of the cancerization field. The above variables will be compared between the groups using a t-test, 95% confidence interval for the between-group difference will be provided.
measure: Absence of new lesions after a follow-up period of 6 months
time frame: 6-month follow-up
description: The count of AK lesions will be performed by exploration and palpation (numeric count) and the presence will be also confirmed by dermoscopic assessment (numeric count)
measure: cosmetic outcome
time frame: 6-month follow-up
description: cosmetic outcome will be evaluated by Patient's assessment of satisfaction to product at the end of the treatment period (specific questionnaire)
arm group label: Ingenol mebutate
arm group type: Active Comparator
description: application of ingenol mebutate for 3 consecutive days on an area of face/scalp of 25 cm2
arm group label: cryotherapy
arm group type: Active Comparator
description: application of criotherapy on actinic keratosis present in an area of face/scalp of 25 cm2 different from the ingenol mebutate area
intervention type: Drug
intervention name: Ingenol mebutate
description: 150 mcg / g per day, to be applied on a predetermined area of 25 cm2 of skin of the face or scalp, for 3 days consecutive
arm group label: Ingenol mebutate
other name: Picato
intervention type: Procedure
intervention name: cryotherapy
description: application with 5 seconds of freezing time of each lesion located in a predetermined skin area of 25 cm2 of the face or scalp
arm group label: cryotherapy
other name: cryosurgery
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Giuseppe Argenziano, Prof
role: Principal Investigator
affiliation: University of Campania "Luigi Vanvitelli"
facility: 
country: Italy
citation: Frost CA, Green AC. Epidemiology of solar keratoses. Br J Dermatol. 1994 Oct;131(4):455-64. doi: 10.1111/j.1365-2133.1994.tb08544.x.
PMID: 7947197
citation: Fu W, Cockerell CJ. The actinic (solar) keratosis: a 21st-century perspective. Arch Dermatol. 2003 Jan;139(1):66-70. doi: 10.1001/archderm.139.1.66. No abstract available.
PMID: 12533168
citation: Ortonne JP. From actinic keratosis to squamous cell carcinoma. Br J Dermatol. 2002 Apr;146 Suppl 61:20-3. doi: 10.1046/j.1365-2133.146.s61.6.x.
PMID: 11966728
citation: Cohen JL. Actinic keratosis treatment as a key component of preventive strategies for nonmelanoma skin cancer. J Clin Aesthet Dermatol. 2010 Jun;3(6):39-44.
PMID: 20725550
citation: Padilla RS, Sebastian S, Jiang Z, Nindl I, Larson R. Gene expression patterns of normal human skin, actinic keratosis, and squamous cell carcinoma: a spectrum of disease progression. Arch Dermatol. 2010 Mar;146(3):288-93. doi: 10.1001/archdermatol.2009.378.
PMID: 20231500
citation: Vatve M, Ortonne JP, Birch-Machin MA, Gupta G. Management of field change in actinic keratosis. Br J Dermatol. 2007 Dec;157 Suppl 2:21-4. doi: 10.1111/j.1365-2133.2007.08268.x.
PMID: 18067627
citation: Fidler B, Goldberg T. Ingenol mebutate gel (picato): a novel agent for the treatment of actinic keratoses. P T. 2014 Jan;39(1):40-6.
PMID: 24672213
citation: Andrews MD. Cryosurgery for common skin conditions. Am Fam Physician. 2004 May 15;69(10):2365-72.
PMID: 15168956
responsible party type: Principal Investigator
investigator affiliation: University of Campania "Luigi Vanvitelli"
investigator full name: Giuseppe Argenziano
investigator title: Professor
mesh term: Keratosis, Actinic
mesh term: Keratosis
sharing ipd: No