Imiquimod reactivation of lichen planus
Domingues, E.; Chaney, K.C.; Scharf, M.J.; Wiss, K.
Cutis 89(6): 276-277; 283
2012
ISSN/ISBN: 0011-4162 PMID: 22838091 Document Number: 13000
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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