A case of topical imiquimod induced fatigue.

Topical imiquimod is used for a variety of common dermatologic lesions, including melanoma in-situ. As an immunomodulator, it is relatively well tolerated with minimal side effects, including scaling, erythema, and edema. Here we present a rare systemic adverse effect, where our patient experienced debilitating severe fatigue when applying imiquimod to a single lesion. Clinicians should be mindful of this side effect and counsel patients appropriately.