Imiquimod-induced subacute cutaneous lupus erythematosus-like changes

Area of Science:

• Dermatology
• Immunology
• Cutaneous Medicine

Background:

• Imiquimod is a topical immunomodulator activating toll-like receptor 7 (TLR7), inducing proinflammatory cytokines.
• Subacute cutaneous lupus erythematosus (SCLE) is typically associated with systemic medications.
• SCLE induced by topical agents is infrequently reported in medical literature.

Observation:

• A 50-year-old woman developed skin lesions after topical imiquimod treatment.
• The lesions exhibited clinical and histological features consistent with SCLE.
• This localized reaction occurred at the site of topical imiquimod application.

Findings:

• The patient's presentation suggests a potential causal link between topical imiquimod and SCLE development.
• Histopathological examination confirmed SCLE-like changes in the affected skin.
• The immunomodulatory effects of imiquimod may play a role in the pathogenesis of this reaction.

Implications:

• This case expands the known spectrum of adverse reactions to topical imiquimod.
• Clinicians should consider SCLE in the differential diagnosis of patients using topical imiquimod who develop lupus-like skin lesions.
• Further investigation into the mechanisms underlying imiquimod-induced SCLE is warranted.