Imiquimod reactivation of lichen planus
Division of Dermatology
Medical Subject Headings
Adjuvants, Immunologic; Administration, Topical; Adult; Aminoquinolines; Anti-Inflammatory Agents; Cheilitis; Clobetasol; Follow-Up Studies; Humans; Lichen Planus; Lip; Male; Treatment Outcome
Dermatology | Pharmacology | Skin and Connective Tissue Diseases
A 44-year-old man who was previously diagnosed with actinic cheilitis was prescribed imiquimod cream 5%, which resulted in thick hemorrhagic crusting of the lower lip after 4 applications. He subsequently noted the development of lichen planus lesions on his arms and legs for the first time in 15 years following imiquimod use. On follow-up he also was noted to have characteristic Wickham striae on his lower lip. Lichen planus is an autoimmune inflammatory condition in which autoreactive T lymphocytes attack keratinocytes. The mechanism of action for imiquimod is upregulation of IFN-alpha and IFN-beta. Treatment with clobetasol cream 0.05% led to resolution of his lichen planus lesions.
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Citation: Cutis. 2012 Jun;89(6):276-7, 283.
Domingues, Erik; Chaney, Keri C.; Scharf, Mark J.; and Wiss, Karen, "Imiquimod reactivation of lichen planus" (2012). Dermatology Publications and Presentations. 56.