A topical imiquimod-induced oral mucosal lichenoid reaction: a case report.

BACKGROUND: Imiquimod (IMI) is a topical immune response modifier used in the treatment of actinic keratosis and cheilitis. Actinic cheilitis is a potentially premalignant condition that requires therapeutic intervention. IMI therapy is noted for producing cutaneous and mucosal adverse effects. The authors report the case of an 88-year-old woman who was treated for actinic cheilitis of the upper lip with IMI and who consequently experienced an oral mucosal lichenoid reaction of the lower lip and right buccal mucosa.

RESULTS: The patient was treated successfully with high-dose steroid therapy, and the oral lesions resolved in 17 days.

CONCLUSIONS: To our knowledge, this is the first case report regarding an IMI-induced oral mucosal lichenoid reaction. Clinicians should be aware of the potential of IMI to cause lichenoid reactions.

PRACTICAL IMPLICATIONS: IMI is an efficacious therapeutic agent when used in the treatment of actinic cheilitis, but it is prone to cause oral mucosal side effects such as lichenoid reactions. Therefore, it is important for dentists to be knowledgeable concerning potential mucosal IMI side effects.