Development of subacute cutaneous lupus erythematosus associated with the use of imiquimod to treat actinic keratoses
Burnett, T.J.; English, J.C.; Ferris, L.K.
Journal of Drugs in Dermatology Jdd 9(8): 1022-1024
2010
ISSN/ISBN: 1545-9616 PMID: 20684157 Document Number: 12011
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.
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