Induction of vitiligo after imiquimod treatment of condylomata acuminata

Wenfei Li,Lingzhi Ge,Hongyan Xin,Haiyan Song,Wang Cao

doi:10.1186/1471-2334-14-329

Abstract

BackgroundCondylomata acuminata (genital warts) is the most common sexually transmitted disease, and imiquimod is the sole FDA-approved medication for combating this condition. Vitiligo associated with imiquimod treatment of condylomata acuminata is rare.Case presentationA 28-year-old male with condylomata acuminata of the penis presented to our clinic. After removing his condylomata acuminata, we advised him to use imiquimod 5% cream to prevent relapse. When he presented to our clinic again about 12 weeks later, he complained of vitiligo patches on his penis and scrotum. Physical examination showed vitiligo patches involving the glans penis, shaft of the penis, and scrotum, and remaining pigmented areas within the plaques of vitiligo.A skin biopsy of the dorsal surface of the penis showed a complete absence of melanocytes and melanin granules in the basal layer; the dermis was normal.ConclusionThis is the first report of a case of imiquimod-induced vitiligo diagnosed by histopathological examination. This adverse effect should be considered when dermatologists prescribe this medication.

Highlights

Condylomata acuminata is the most common sexually transmitted disease, and imiquimod is the sole FDA-approved medication for combating this condition
This is the first report of a case of imiquimod-induced vitiligo diagnosed by histopathological examination
It is caused by human papilloma virus (HPV) infection, which may contribute to cervical cancer [1]

Summary

Background

Condylomata acuminata (genital warts) is the most common sexually transmitted disease. Case presentation A 28-year-old Chinese male presented to our clinic with a 3-year history of condylomata acuminata of the penis His lesions had been previously treated several times with liquid nitrogen and electrodessication without causing any pigmentary changes, but his problem had relapsed half a month before presentation and he was presenting with five new warts. The patient was treated with electrodessication to remove his condylomata acuminata When his wound healed 12 days later, he was advised to use imiquimod 5% cream for relapse prevention. Melanocytes and melanin granules exist in the epidermal basal-cell layer of normal skin (Figure 4) He was diagnosed, clinically and pathologically, with imiquimod-induced localized vitiligo

Discussion

Findings

Conclusion

13. Skinner RB Jr