Pasadyn Selena R, Cain Robert
Ms. Pasadyn and Dr. Cain are with the Cleveland Clinic Lerner College of Medicine in Cleveland, Ohio.
J Clin Aesthet Dermatol. 2019 Jun;12(6):58-59. Epub 2019 Jun 1.
Imiquimod can be used to treat superficial basal cell carcinoma, actinic keratosis, genital warts, and other skin conditions. The adverse events associated with this topical agent commonly include application site irritation, primarily erythema, as well as headache, myalgia, and fatigue. There are usually minimal systemic symptoms. We report the case of a patient who used topical imiquimod 5% cream on nine basal cell carcinoma lesions daily for three days and developed severe muscle weakness and the inability to walk. He fell twice, went to the emergency department, and was given 125mg injection of methylprednisolone. The imiquimod was then discontinued and he recovered almost back to baseline in 48 hours. We hypothesize the patient's reaction to the imiquimod was due to an immune etiology, potentially involving TLR7 and NF-κB as precipitators of this myopathy. Overall, this report demonstrates a potential severe and rapid adverse reaction to topical imiquimod administration not previously reported in the literature.
咪喹莫特可用于治疗浅表性基底细胞癌、光化性角化病、尖锐湿疣及其他皮肤疾病。与这种局部用药相关的不良事件通常包括用药部位刺激，主要是红斑，以及头痛、肌痛和疲劳。通常全身症状轻微。我们报告一例患者，其每日在九个基底细胞癌皮损上外用5%咪喹莫特乳膏，持续三天，随后出现严重肌无力及无法行走的情况。他跌倒两次，前往急诊科，接受了125mg甲泼尼龙注射。随后停用咪喹莫特，他在48小时内几乎恢复至基线水平。我们推测该患者对咪喹莫特的反应是由免疫病因引起的，可能涉及TLR7和NF-κB作为这种肌病的诱发因素。总体而言，本报告显示了外用咪喹莫特给药可能出现的一种严重且迅速的不良反应，这在以往文献中未曾报道过。
