title: Development of subacute cutaneous lupus erythematosus associated with the use of imiquimod to treat actinic keratoses.
abstract: The immunomodulating drug imiquimod is approved by the U.S. Food and Drug Administration (FDA) to treat actinic keratoses, non-facial superficial basal cell carcinomas and genital warts. This drug elicits its immunological response by binding to toll-like receptor 7 (TLR-7) on dendritic cells inducing the production of interferon alpha (IFN-alpha) and other inflammatory cytokines. The authors report the case of a 56-year-old female who developed subacute cutaneous lupus erythematosus (SCLE), as well as severe autoimmune retinitis following a vigorous response to imiquimod 5% cream that was prescribed to treat actinic keratoses. Given the important role of IFN-alpha in the pathogenesis of cutaneous lupus, it is likely that imiquimod either induced or unmasked an autoimmune tendency in this patient.
authors.affiliation: United States Air Force, WPAFB, OH, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Burnett
authors.forename: Joseph C
authors.initials: JC
authors.lastname: English
authors.forename: Laura Korb
authors.initials: LK
authors.lastname: Ferris
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000279:Administration, Cutaneous; D000634:Aminoquinolines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000139:chemically induced; D005260:Female; D006801:Humans; D000077271:Imiquimod; D055623:Keratosis, Actinic / Q000188:drug therapy; D008178:Lupus Erythematosus, Cutaneous / Q000139:chemically induced*; D008875:Middle Aged; D012173:Retinitis / Q000139:chemically induced / Q000276:immunology; D012720:Severity of Illness Index
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000077271:Imiquimod