Exacerbation of atopic dermatitis in a patient treated with infliximab.

in the literature on the use of imiquimod in EMPD, found complete remission of the disease in 21 of the 27 reported cases (78%). The factors that influence the success or failure of imiquimod therapy in this setting have not yet been clearly established. Factors that might explain the variability of response to treatment include the size of the lesion, its variable thickness in different areas, and the presence of extensive adnexal involvement. We agree with Hiraldo-Gamero that the small number of published cases makes it difficult to draw conclusions concerning the efficacy and safety of 5% imiquimod cream in selected cases of EMPD. Our report provides additional evidence on the medium-term safety of this treatment and represents the longest follow-up period free of disease reported in the dermatologic literature.