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Although controversial, the use of imiquimod for the treatment of primary melanoma in-situ (MIS) and residual MIS after surgical excisions has become more common. This is especially true in patients with multiple medical comorbidities, treatment of cosmetically sensitive areas and when surgical intervention would lead to significant functional impairment. Recognizing imiquimod-induced lupus-like reactions on histology is important and necessitates good clinicopathologic correlation given the potential ramifications of unnecessary laboratory workup and the need for systemic medications can be avoided. We report a case of lupus erythematous-like reaction in a patient being treated with imiquimod for residual MIS of the face.

Imiquimod-Induced Cutaneous Lupus-like Reaction: A Potential Histologic Pitfall Highlighting the Importance of Clinico-pathologic Correlation