Topical Imiquimod and Subsequent Erythema Multiforme

Maxfield, Luke; Gaston, David A.; Peck, Aurora; Hansen, Katrina

doi:10.7556/jaoa.2020.010

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…Imiquimod is a TLR7 (and TLR8 in humans) agonist used for the treatment of superficial basal cell carcinomas, actinic keratoses and some viral skin infections. A range of cutaneous adverse effects has been described, including psoriasis, dermatitis, erythema multiforme, vesiculation, alopecia, lichenoid reactions, lupus erythematosus, neutrophilic diseases, oral erosions and Stevens-Johnson syndrome [32][33][34][35][36][37][38][39][40][41] , which underlie the murine inflammatory skin model.…”

Section: Anti-cd1a Antibodies Prevent Imiquimod-induced Skin Inflamma...mentioning

confidence: 99%

CD1a promotes systemic manifestations of skin inflammation

et al. 2022

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Inflammatory skin conditions are increasingly recognised as being associated with systemic inflammation. The mechanisms connecting the cutaneous and systemic disease are not well understood. CD1a is a virtually monomorphic major histocompatibility complex (MHC) class I-like molecule, highly expressed by skin and mucosal Langerhans cells, and presents lipid antigens to T-cells. Here we show an important role for CD1a in linking cutaneous and systemic inflammation in two experimental disease models. In human CD1a transgenic mice, the toll-like receptor (TLR)7 agonist imiquimod induces more pronounced splenomegaly, expansion of the peripheral blood and spleen T cell compartments, and enhanced neutrophil and eosinophil responses compared to the wild-type, accompanied by elevated skin and plasma cytokine levels, including IL-23, IL-1α, IL-1β, MCP-1 and IL-17A. Similar systemic escalation is shown in MC903-induced skin inflammation. The exacerbated inflammation could be counter-acted by CD1a-blocking antibodies, developed and screened in our laboratories. The beneficial effect is epitope dependent, and we further characterise the five best-performing antibodies for their capacity to modulate CD1a-expressing cells and ameliorate CD1a-dependent systemic inflammatory responses. In summary, we show that a therapeutically targetable CD1a-dependent pathway may play a role in the systemic spread of cutaneous inflammation.

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Section: Anti-cd1a Antibodies Prevent Imiquimod-induced Skin Inflamma...mentioning

confidence: 99%

CD1a promotes systemic manifestations of skin inflammation

et al. 2022

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Diagnosis

Isola

Santonocito

Leonardi

et al. 2023

Oral Lichen Planus and Lichenoid Lesions

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Rare Cutaneous Side Effects of Imiquimod: A Review on Its Mechanisms, Diagnosis, and Management

Zhang

Xie

Wang

2023

Dermatol Ther (Heidelb)

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As an immune-response modifier, imiquimod can bind to Toll-like receptors on immune cells and enhance innate and adaptive immune responses, exerting potential antitumor and antiviral effects, which led to its approval by the US Food and Drug Administration for the treatment of actinic keratosis, superficial basal cell carcinomas, and anogenital warts, and to its off-label use in treating many other benign and malignant dermatoses. Although topical administration of imiquimod has been considered well tolerated, an increasing number of cutaneous and noncutaneous side effects are being reported as its clinical applications expand. This review primarily focuses on rare cutaneous side effects. To the best of our knowledge, this is the first article to summarize the mechanism, diagnosis, and management of rare cutaneous side effects of imiquimod, which may help to heighten awareness among physicians, especially dermatologists, about potential imiquimod-induced cutaneous side effects.

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Topical Imiquimod and Subsequent Erythema Multiforme

Cited by 4 publications

References 10 publications

CD1a promotes systemic manifestations of skin inflammation

CD1a promotes systemic manifestations of skin inflammation

Diagnosis

Rare Cutaneous Side Effects of Imiquimod: A Review on Its Mechanisms, Diagnosis, and Management

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