Topical Imiquimod and Subsequent Erythema Multiforme.

Area of Science:

• Dermatology
• Dermatologic Surgery
• Adverse Drug Reactions

Background:

• Topical imiquimod is a standard treatment for actinic keratosis and superficial basal cell carcinoma.
• Adverse effects are typically localized irritation.
• Erythema multiforme is a rare but serious potential adverse reaction.

Purpose of the Study:

• To report a rare case of erythema multiforme following topical imiquimod use.
• To describe the clinical presentation and management of this adverse reaction.

Main Methods:

• Case report of a patient treated with topical imiquimod.
• Detailed description of the adverse reaction's onset, presentation, and resolution.

Main Results:

• The patient developed widespread erythema multiforme involving oral mucosa, trunk, and extremities.
• The reaction occurred after broad application of topical imiquimod for actinic keratosis and suspected superficial basal cell carcinoma.
• Symptoms resolved promptly after discontinuing imiquimod and initiating systemic corticosteroids.

Conclusions:

• Topical imiquimod, despite a generally favorable safety profile, can rarely induce severe cutaneous reactions like erythema multiforme.
• Clinicians should be aware of this rare adverse effect, especially with extensive application.
• Prompt recognition and management, including drug cessation and corticosteroid therapy, are crucial for resolution.