Imiquimod-induced bullous pemphigoid: A case report
A 72-year-old man treated with 3.5% imiquimod cream for scalp actinic keratoses developed the usual crusted and erosive reaction but developed bullae on the scalp, as well as the limbs and torso after several weeks into treatment. Biopsy confirmed bullous pemphigoid. He was treated with clobetasol o...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-03-01
|
| Series: | SAGE Open Medical Case Reports |
| Online Access: | https://doi.org/10.1177/2050313X231164222 |
| _version_ | 1797854958784086016 |
|---|---|
| author | Heidi Oi-Yee Li Michael Aw Steven J Glassman |
| author_facet | Heidi Oi-Yee Li Michael Aw Steven J Glassman |
| author_sort | Heidi Oi-Yee Li |
| collection | DOAJ |
| description | A 72-year-old man treated with 3.5% imiquimod cream for scalp actinic keratoses developed the usual crusted and erosive reaction but developed bullae on the scalp, as well as the limbs and torso after several weeks into treatment. Biopsy confirmed bullous pemphigoid. He was treated with clobetasol ointment, prednisone and methotrexate, with eventual disease control. He had a severe disease course. Bullous pemphigoid is usually idiopathic, but can be induced by skin trauma, as well as by several medications; this is the first report of imiquimod as a trigger. Imiquimod is a toll-like receptor 7 agonist that induces cellular apoptosis and recruits pro-inflammatory cytokines including tumour necrosis factor-alpha and interferon-alpha, which have been implicated in autoimmunity. This case highlights an unusual but severe adverse effect from topical imiquimod. |
| first_indexed | 2024-04-09T20:15:48Z |
| format | Article |
| id | doaj.art-cfb77cd1662047fbbc076fd3e75443b8 |
| institution | Directory Open Access Journal |
| issn | 2050-313X |
| language | English |
| last_indexed | 2024-04-09T20:15:48Z |
| publishDate | 2023-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medical Case Reports |
| spelling | doaj.art-cfb77cd1662047fbbc076fd3e75443b82023-03-31T10:05:43ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2023-03-011110.1177/2050313X231164222Imiquimod-induced bullous pemphigoid: A case reportHeidi Oi-Yee Li0Michael Aw1Steven J Glassman2Faculty of Medicine, University of Ottawa, Ottawa, ON, CanadaFaculty of Medicine, University of Ottawa, Ottawa, ON, CanadaDivision of Dermatology, University of Ottawa and The Ottawa Hospital, Ottawa, ON, CanadaA 72-year-old man treated with 3.5% imiquimod cream for scalp actinic keratoses developed the usual crusted and erosive reaction but developed bullae on the scalp, as well as the limbs and torso after several weeks into treatment. Biopsy confirmed bullous pemphigoid. He was treated with clobetasol ointment, prednisone and methotrexate, with eventual disease control. He had a severe disease course. Bullous pemphigoid is usually idiopathic, but can be induced by skin trauma, as well as by several medications; this is the first report of imiquimod as a trigger. Imiquimod is a toll-like receptor 7 agonist that induces cellular apoptosis and recruits pro-inflammatory cytokines including tumour necrosis factor-alpha and interferon-alpha, which have been implicated in autoimmunity. This case highlights an unusual but severe adverse effect from topical imiquimod.https://doi.org/10.1177/2050313X231164222 |
| spellingShingle | Heidi Oi-Yee Li Michael Aw Steven J Glassman Imiquimod-induced bullous pemphigoid: A case report SAGE Open Medical Case Reports |
| title | Imiquimod-induced bullous pemphigoid: A case report |
| title_full | Imiquimod-induced bullous pemphigoid: A case report |
| title_fullStr | Imiquimod-induced bullous pemphigoid: A case report |
| title_full_unstemmed | Imiquimod-induced bullous pemphigoid: A case report |
| title_short | Imiquimod-induced bullous pemphigoid: A case report |
| title_sort | imiquimod induced bullous pemphigoid a case report |
| url | https://doi.org/10.1177/2050313X231164222 |
| work_keys_str_mv | AT heidioiyeeli imiquimodinducedbullouspemphigoidacasereport AT michaelaw imiquimodinducedbullouspemphigoidacasereport AT stevenjglassman imiquimodinducedbullouspemphigoidacasereport |