title: Imiquimod reactivation of lichen planus.
abstract: 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.
authors: Division of Dermatology, University of Massachusetts Medical School, Worcester, MA 01605, USA. mark.scharf@umassmemorial.org
authors: Erik
authors: E
authors: Domingues
authors: Keri C
authors: KC
authors: Chaney
authors: Mark J
authors: MJ
authors: Scharf
authors: Karen
authors: K
authors: Wiss
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000287:Administration, Topical; D000328:Adult; D000634:Aminoquinolines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002613:Cheilitis / Q000188:drug therapy; D002990:Clobetasol / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D000077271:Imiquimod; D008010:Lichen Planus / Q000209:etiology* / Q000473:pathology; D008046:Lip; D008297:Male; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000893:Anti-Inflammatory Agents; D002990:Clobetasol; D000077271:Imiquimod