2004
DOI: 10.1111/j.1440-0960.2004.00030.x
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Psoriasis induced by topical imiquimod

Abstract: We report the provocation of localized psoriasis at the sites of application of topical imiquimod, possibly evolving into a generalized flare. A patient with pre-existing psoriasis that had been stable for 14 years was treated with imiquimod 5% cream daily for 6 weeks to three superficial basal cell carcinomas. During treatment one of the lesions developed severe local skin reactions necessitating rest periods, and received only 18 applications in 6 weeks. The other two lesions were treated for all 42 days. Ps… Show more

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Cited by 131 publications
(91 citation statements)
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“…IMQ can exacerbate psoriasis in patients with a well-controlled psoriasis during topical treatment of actinic keratoses and superficial basal cell carcinomas (4 -7). IMQinduced exacerbation of psoriasis occurs at both the treated area and, interestingly, also at distant skin sites that were previously unaffected (5)(6)(7). Furthermore suggestive for systemic effects of topical IMQ application are our own clinical observations that patients with IMQ-induced psoriasis at distant body sites exhibit flulike symptoms (unpublished data).…”
mentioning
confidence: 83%
“…IMQ can exacerbate psoriasis in patients with a well-controlled psoriasis during topical treatment of actinic keratoses and superficial basal cell carcinomas (4 -7). IMQinduced exacerbation of psoriasis occurs at both the treated area and, interestingly, also at distant skin sites that were previously unaffected (5)(6)(7). Furthermore suggestive for systemic effects of topical IMQ application are our own clinical observations that patients with IMQ-induced psoriasis at distant body sites exhibit flulike symptoms (unpublished data).…”
mentioning
confidence: 83%
“…This model, which is IL-23 dependent, involves daily topical application of the TLR7 agonist imiquimod formulated in a commercially available cream, Aldara (28). Aldara has been used for some time in the treatment of a variety of dermal malignancies such as actinic keratoses and superficial basal cell carcinomas (29,30); however, a side effect of such treatment is the exacerbation of psoriatic lesions in some patients, even those with well controlled psoriasis (31,32). On the basis of this observation, use of Aldara in murine studies as an inducer of psoriasiform inflammation has come to be accepted as a clinically faithful model of psoriasis, particularly as the pathological manifestations induced bear striking similarities to human psoriasis but also because it is responsive to a range of the current frontline psoriasis therapies (9,10,28).…”
Section: Resultsmentioning
confidence: 99%
“…In contrast, levels of TLR5 are lower in psoriatic than in nonlesional epidermis. Most interestingly, several cases are described in literature where topical applications of the TLR7 agonist imiquimod lead to aggravation of psoriatic plaques (122)(123)(124)(125).…”
Section: Tlrs In Psoriasismentioning
confidence: 99%