Imiquimod has immune-stimulant properties that can precipitate autoimmune conditions like eczema, psoriasis and lichenoid conditions. We report two cases here where imiquimod induced florid lichen sclerosus in one patient and lichen planus in another. In both patients the condition was so aggressive and unresponsive to steroid treatment that circumcision was necessary.
O'MahonyC. Difficult wart cases – use of imiquimod cream 5%. Int J STD AIDS2001;12:400–3
2.
McInturffJE, ModlinRL, KimJ. The role of toll-like receptors in the pathogenesis and treatment of dermatological disease. J Invest Dermatol2005;125:1–8
3.
RajanN, LangtryJAA. Generalised exacerbation of psoriasis associated with imiquimod cream treatment of superficial basal cell carcinomas. Br J Dermatol2005;31:140–1
4.
TaylorCL, MaslenM, KapembwaM. A case of severe eczema following use of imiquimod 5% cream. Sex Transm Infect2006;82:227–8
5.
SuomelaS, CaoL, BowcockA, Saarialho-KereU. Interferon alpha-inducible protein 27 (IF127) is upregulated in psoriatic skin and certain epithelial cancers. J Invest Dermatol2004;122:717–21
6.
WenzelJ, PetersB, ZahnS, Gene expression profiling of lichen planus reflects CXCL9 + -mediated inflammation and distinguishes this disease from atopic dermatitis and psoriasis. J Invest Dermatol2007;128:67–78
7.
WenzelJ, TutingT. An IFN-associated cytotoxic cellular immune response against viral, self- or tumor antigens is a common pathogenetic feature in ‘interface dermatitis’. J Invest Dermatol2008;128:2392–402
8.
WenzelJ, WiechertA, MerkelC, BieberT, TutingT. IP10/CXCL10–CXCR3 interaction: a potential self-recruiting mechanism for cytotoxic lmphocytes in lichen sclerosus et atrophicus. Acta Dermato-Venereologica2007;87:112–17
