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Ingenol mebutate, the active component of Euphorbia peplus (radium weed), has been used in Australia to treat various skin conditions, including actinic keratoses (AKs). Its mechanism of action involves rapid induction of primary necrosis followed by development of neutrophil-mediated, antibody-dependent cellular cytotoxicity in residual diseased cells. In this multicenter, randomized, double-blind, vehicle-controlled, parallel-group Australian study, 57 patients received two applications of ingenol mebutate gel (IMG) or placebo to five nonhypertrophic AKs, one biopsy-proven. Applications occurred either on days 1 and 2 or on days 1 and 8. Patients in the treatment group received one of three concentrations of IMG: 0.0025%, 0.01%, or 0.05%.…