Imiquimod

In a report, two women, aged 31 and 32, developed telogen effluvium (a form of temporary hair loss) and other adverse reactions such as fever, fatigue, flu-like symptoms, myalgia, headache, dizziness, weight loss, vaginal discharge, and genital itching during treatment with imiquimod for cervical intraepithelial neoplasia (CIN). Both women were part of a clinical trial and were using intravaginal applications of imiquimod. The 31-year-old received a cumulative dose of 71.875mg and experienced systemic side effects, while the 32-year-old received a cumulative dose of 250mg and developed local reactions in addition to systemic symptoms. Other potential causes for hair loss were ruled out in both cases. The hair loss and other symptoms subsided after discontinuation of imiquimod treatment. The authors noted that while local side effects like erythema and systemic side effects such as flu-like symptoms are known, these cases presented telogen effluvium as a result of the imiquimod treatment.