Stevens-Johnson Syndrome and Erythema Multiforme Induced by Imiquimod 5% Cream
Introduction: Topical imiquimod is a safe and effective treatment for actinic keratoses, superficial basal cell carcinomas and anogenital warts. The treatment is commonly associated with local inflammatory reactions, while systemic side effects are rare and generally mild. Only few cases of erythem...
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Mattioli1885
2025-01-01
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| Series: | Dermatology Practical & Conceptual |
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| Online Access: | https://dpcj.org/index.php/dpc/article/view/4629 |
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| author | Ilaria Salvi Ilaria Trave Riccardo Castelli Aurora Parodi Emanuele Cozzani |
| author_facet | Ilaria Salvi Ilaria Trave Riccardo Castelli Aurora Parodi Emanuele Cozzani |
| author_sort | Ilaria Salvi |
| collection | DOAJ |
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Introduction: Topical imiquimod is a safe and effective treatment for actinic keratoses, superficial basal cell carcinomas and anogenital warts. The treatment is commonly associated with local inflammatory reactions, while systemic side effects are rare and generally mild. Only few cases of erythema multiforme and Stevens-Johnson syndrome have been described in association with topical imiquimod application.
Objective: We present a review of the existing cases of erythema multiforme and Stevens-Johnson syndrome reported in the literature, analyzing the clinical appearance, the histology and the treatment of the lesions.
Method: Nine case of erythema multiforme were reported, characterized by cutaneous rash, bullae, crusting, erosive and targetoid lesions, mainly located at the extremities. Mucosal involvement and systemic symptoms were sometimes present.
Results: Three cases of Stevens-Johnson syndrome were associated with topical imiquimod. In all cases, the authors reported targetoid lesions and areas of erosion affecting trunk and limbs, associated with systemic symptoms, and, in 2 cases, to mucosal erosions.
Conclusions: We hypothesize a possible role of interferon-γ, a cytokine involved in the pathogenesis of both herpes-associated erythema multiforme and Stevens-Johnson syndrome, which is released in response to the administration of imiquimod.
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| format | Article |
| id | doaj-art-f8084b536a71428fb8d3616cab110095 |
| institution | Kabale University |
| issn | 2160-9381 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Mattioli1885 |
| record_format | Article |
| series | Dermatology Practical & Conceptual |
| spelling | doaj-art-f8084b536a71428fb8d3616cab1100952025-02-04T15:41:40ZengMattioli1885Dermatology Practical & Conceptual2160-93812025-01-0115110.5826/dpc.1501a4629Stevens-Johnson Syndrome and Erythema Multiforme Induced by Imiquimod 5% CreamIlaria Salvi0https://orcid.org/0000-0003-0151-3126Ilaria Trave1https://orcid.org/0000-0002-5469-4517Riccardo Castelli2https://orcid.org/0000-0002-7184-7888Aurora Parodi3Emanuele Cozzani4Department of Dermatology, Dipartimento della Salute (DiSSal), University of Genoa; IRCCS, Ospedale Policlinico San Martino, Genoa, Italy.Department of Dermatology, Dipartimento della Salute (DiSSal), University of Genoa; IRCCS, Ospedale Policlinico San Martino, Genoa, Italy.Department of Dermatology, Dipartimento della Salute (DiSSal), University of Genoa; IRCCS, Ospedale Policlinico San Martino, Genoa, Italy.Department of Dermatology, Dipartimento della Salute (DiSSal), University of Genoa; IRCCS, Ospedale Policlinico San Martino, Genoa, Italy.Department of Dermatology, Dipartimento della Salute (DiSSal), University of Genoa; IRCCS, Ospedale Policlinico San Martino, Genoa, Italy. Introduction: Topical imiquimod is a safe and effective treatment for actinic keratoses, superficial basal cell carcinomas and anogenital warts. The treatment is commonly associated with local inflammatory reactions, while systemic side effects are rare and generally mild. Only few cases of erythema multiforme and Stevens-Johnson syndrome have been described in association with topical imiquimod application. Objective: We present a review of the existing cases of erythema multiforme and Stevens-Johnson syndrome reported in the literature, analyzing the clinical appearance, the histology and the treatment of the lesions. Method: Nine case of erythema multiforme were reported, characterized by cutaneous rash, bullae, crusting, erosive and targetoid lesions, mainly located at the extremities. Mucosal involvement and systemic symptoms were sometimes present. Results: Three cases of Stevens-Johnson syndrome were associated with topical imiquimod. In all cases, the authors reported targetoid lesions and areas of erosion affecting trunk and limbs, associated with systemic symptoms, and, in 2 cases, to mucosal erosions. Conclusions: We hypothesize a possible role of interferon-γ, a cytokine involved in the pathogenesis of both herpes-associated erythema multiforme and Stevens-Johnson syndrome, which is released in response to the administration of imiquimod. https://dpcj.org/index.php/dpc/article/view/4629ImiquimodStevens-Johnson SyndromeErythema multiformeAdverse Drug Reactions |
| spellingShingle | Ilaria Salvi Ilaria Trave Riccardo Castelli Aurora Parodi Emanuele Cozzani Stevens-Johnson Syndrome and Erythema Multiforme Induced by Imiquimod 5% Cream Dermatology Practical & Conceptual Imiquimod Stevens-Johnson Syndrome Erythema multiforme Adverse Drug Reactions |
| title | Stevens-Johnson Syndrome and Erythema Multiforme Induced by Imiquimod 5% Cream |
| title_full | Stevens-Johnson Syndrome and Erythema Multiforme Induced by Imiquimod 5% Cream |
| title_fullStr | Stevens-Johnson Syndrome and Erythema Multiforme Induced by Imiquimod 5% Cream |
| title_full_unstemmed | Stevens-Johnson Syndrome and Erythema Multiforme Induced by Imiquimod 5% Cream |
| title_short | Stevens-Johnson Syndrome and Erythema Multiforme Induced by Imiquimod 5% Cream |
| title_sort | stevens johnson syndrome and erythema multiforme induced by imiquimod 5 cream |
| topic | Imiquimod Stevens-Johnson Syndrome Erythema multiforme Adverse Drug Reactions |
| url | https://dpcj.org/index.php/dpc/article/view/4629 |
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