title: Vulvar vitiligo-like depigmentation and multiple halos of hypomelanosis at the trunk following treatment with imiquimod 5% cream for vulvar condylomata: casual or related events?
abstract: A 25-year-old Caucasian female with multiple genital warts involving the vulvar area was treated with imiquimod 5% cream. During follow-up the patient developed areas of hypopigmentation at the site of application of imiquimod cream and areas of hypomelanosis around multiple preexisting nevi of the trunk. At 18 months follow-up genital depigmentation persisted and halo nevi of the trunk were still present. Different mechanisms of imiquimod-induced depigmentation have been reported. Halo nevi are considered expression of an autoimmune response. In the case presented here, it might be conceivable that both vitiligo-like depigmentation at the site of application and halo of hypomelanosis around melanocytic nevi have been induced by the same immunologic mechanism elicited by topical application of imiquimod.
authors.affiliation: Divisione Melanoma, Istituto Europeo di Oncologia, Milano, Italia.
authors.forename: Maíra Chiarelli
authors.initials: MC
authors.lastname: Serra
authors.affiliation: Dipartimento di Fisiopatologia Medico-Chirurgica, Ospedale Maggiore Policlinico, Fondazione IRCSS Ca' Granda, Milano, Italia.
authors.forename: Claudia
authors.initials: C
authors.lastname: Menicanti
authors.affiliation: Divisione Melanoma, Istituto Europeo di Oncologia, Milano, Italia.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pennacchioli
authors.affiliation: Divisione Melanoma, Istituto Europeo di Oncologia, Milano, Italia.
authors.forename: Giulio
authors.initials: G
authors.lastname: Tosti
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D000279:Administration, Cutaneous; D000328:Adult; D000634:Aminoquinolines / Q000009:adverse effects*; D003218:Condylomata Acuminata / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077271:Imiquimod; D055882:Nevus, Halo / Q000139:chemically induced* / Q000276:immunology; D012867:Skin / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome; D014820:Vitiligo / Q000139:chemically induced* / Q000276:immunology; D014845:Vulvar Diseases / Q000188:drug therapy*
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000077271:Imiquimod