Picato for the Treatment of Molluscum Contagiosum in Immunocompromised Patients

Inclusion Criteria:

- Male or non-pregnant female at least 18 years of age.

- Subject must have an immunocompromised condition due to use of immunosuppressive
therapies for cancer or autoimmune disease treatment or prevention of organ transplant
rejection or due to an inherited condition that affects the immune system.

- Subject has at least 10 clinically typical, visible and discrete MCs within a
treatment area on either the face and/or trunk. Treatment area is defined as either:

- One contiguous treatment area of at most 100 cm2

- Two non-contiguous treatment areas totaling at most 100 cm2

- Subject must be willing to forego any other treatments of MC on the face and/or trunk,
including tanning bed use and excessive sun exposure, throughout the duration of the
trial.

- Subject is willing and able to participate in the study as an outpatient, making
frequent visits to the study center during the treatment and follow-up periods, and to
comply with all study requirements.

- Female subjects of childbearing potential must have a negative urine pregnancy test
prior to trial treatment.

- Female subjects of childbearing potential must be willing to use effective
contraception at trial entry and until the last follow-up visit at Week 24.

Exclusion Criteria:

- Location of the treatment area

- on the periorbital skin

- within 5 cm of an incompletely healed wound

- within 10 cm of a suspected basal cell carcinoma (BCC) or squamous cell carcinoma
(SCC).

- Previous participation in an ingenol mebutate trial.

- Treatment with ingenol mebutate gel in the treatment area within 6 months or outside
of the treatment area within 30 days prior to study treatment initiation.

- Receipt of the following within 90 days prior to study treatment initiation:

- interferons or interferon inducers

- any dermatologic procedures or surgeries within the treatment area

- Receipt of any topical prescription medications in the treatment area within 30 days
prior to study treatment initiation.

- Lesions in the treatment area have atypical clinical appearance (e.g. giant lesions
greater than 5 mm, eczematous lesions, or folliculocentric lesions).

- Active dermatologic conditions that may confound the diagnosis of MC or would
interfere with assessment of treatment, such as scabies, cutaneous lymphoma, or
psoriasis.

- Clinical diagnosis/history or evidence of any medical condition that would expose a
subject to an undue risk of a severe AE or interfere with assessments of safety and
efficacy during the course of the trial, as determined by the (sub)investigator's
clinical judgment.

- Known history of infection with Human Immunodeficiency Virus (HIV).

- History of melanoma.

- History of chronic alcohol or drug abuse within 12 months prior to screening, or any
condition associated with poor compliance as judged by the (sub)investigator.

- Known or suspected allergy or reaction to any component of the IMP formulation.

- Patients who have experienced a clinically important medical event within 90 days
prior to study treatment initiation (e.g., stroke, myocardial infarction, etc).

- Pregnant, breastfeeding, or lactating women.

- Participation in any another interventional clinical trial within 30 days prior to
study treatment initiation.