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Imiquimod-induced bullous pemphigoid: A case report
Heidi Oi-Yee Li1,2, Michael Aw2, Steven J Glassman1
1Division of Dermatology, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada.
SAGE Open Medical Case Reports
|April 7, 2023
Summary
Topical imiquimod cream, used for actinic keratoses, can trigger bullous pemphigoid, a severe blistering skin condition. This case report details a patient
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Actinic keratoses are common precancerous skin lesions.
- Imiquimod cream is a topical immune response modifier.
- Bullous pemphigoid is a rare autoimmune blistering disease.
Observation:
- A 72-year-old male developed widespread bullae during imiquimod treatment for scalp actinic keratoses.
- Skin biopsy confirmed bullous pemphigoid.
- The patient experienced a severe disease course requiring multiple treatments.
Findings:
- This is the first reported case of imiquimod inducing bullous pemphigoid.
- Imiquimod, a toll-like receptor 7 agonist, may trigger autoimmunity through cytokine induction.
- Potential adverse effects of topical imiquimod include severe blistering.
Implications:
- Clinicians should be aware of imiquimod's potential to induce bullous pemphigoid.
- Further research is needed to understand the mechanism of imiquimod-induced autoimmunity.
- This finding expands the known adverse effects of topical imiquimod therapy.
