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Imiquimod-associated erythema multiforme.
1Department of Dermatovenerology, University Clinical Center Maribor, Maribor, Slovenia.
Acta Dermatovenerologica Alpina, Pannonica, Et Adriatica
|March 25, 2020
Summary
Topical imiquimod effectively treats actinic keratoses but can rarely cause systemic reactions. This case highlights erythema multiforme as a rare adverse effect of imiquimod therapy.
Area of Science:
- Dermatology
- Immunology
Background:
- Actinic keratoses (AK) are common pre-malignant skin lesions.
- Topical imiquimod, an immune-response modifier, is a standard treatment for multiple AKs.
- Common side effects of imiquimod are localized skin reactions.
Observation:
- A 77-year-old patient developed erythema multiforme (EM), a rare systemic reaction.
- EM manifested after initiating topical imiquimod treatment for AKs.
- The patient experienced typical localized adverse effects at the application site.
Findings:
- Systemic adverse reactions to imiquimod, such as EM, are uncommon.
- Discontinuation of imiquimod and application of topical corticosteroids rapidly resolved the EM lesions.
- Cryotherapy was used to treat residual actinic keratoses.
Implications:
- Clinicians should be aware of the potential for rare systemic adverse reactions like EM with topical imiquimod.
- Prompt recognition and management, including drug cessation and supportive care, are crucial for EM.
- Imiquimod remains a valuable treatment for AKs, but risk-benefit assessment is important.
