Imiquimod-induced localized vitiligo in wife and lichen planus in husband

作     者：Wang Hong-wei Miao Fei Shi Lei Lu Ting Huang Zheng Wang Xiu-li 

作者机构：Shanghai Skin Dis Hosp Shanghai 200443 Peoples R China Fudan Univ Huadong Hosp Dept Dermatol Shanghai 200040 Peoples R China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2013年第126卷第13期

页      面：2593-2593页

核心收录：

学科分类：1002[医学-临床医学] 100206[医学-皮肤病与性病学] 10[医学] 

基　　金：国家自然科学基金 上海市自然科学基金 Talent Training Project of Shanghai Health Institute of Shanghai Municipal Health Bureau 

主　　题：Imiquimod-induced Recently Chinese couple 

摘      要：To the editor： The main side effects of topical imiquinaod are dose-dependent application-site reactions. Recently, we founda Chinese couple developed vitiligo-like depigmentation lesions and lichen planus with genital warts after treatment with 5% imiquimod cream, respectively. The wife, 36 years old. was diagnosed with genital warts based on acetic acid white test. Numerous warty lesions were located on both sides of the labia minora and majora, perineal, perianal areas and external cervical orifice. One week after CO2 laser treatment, 5% imiquimod cream （AldaraTM, 3M Pharmaceuticals, USA） was applied to the external genital area every other night to prevent recurrence. Six weeks later, the patient noticed a few spots of slight hypopigmentation at the imiquimod-applied areas and then stopped using the imiquimod cream. But the hypopigmentation gradually became worse and spread to the perineum and perianal areas. Three months later complete depigmentation occurred on the perineum and perianal skin （Figure IA）. Pigment loss in pubic hairs in the imiquimod-applied areas was also visible. The lesions showed clear demarcation lines and did not extend to the areas that had not been treated with imiquimod. The patient had no personal or family history ofvitiligo. She was diagnosed with localized vitiligo. The husband, 37 years old, was also diagnosed with genital warts distributed in the coronal and foreskin areas. One week after the completion of two-session of CO2 laser treatment, 5% imiquimod cream was applied in the same way as his wife for 3 months. One month later, the patient noticed some papular lesions in the imiquimod-applied areas. Three months later, dermatological examination revealed nmltiple purple-red specks （Figure IB）. The patient denied any trauma or history of drug allergy. Histopathological examination revealed hyperkeratosis of the epidermis, local and wedge-type thickening of granular layer, irregular thickening of the cell layer, liquefied degenera