LAUSR

Adult T-cell leukemia/lymphoma (ATL) is a non-Hodgkin lymphoma caused by the human T-lymphotropic virus type 1. The indolent variant manifests on the skin as pruritic papules and plaques. Current treatment regimens for cutaneous ATL include watchful waiting; skin directed therapy, such as radiation, topical steroids, or ultraviolet light; or the use of oral agents, including interferon-α or zidovudine. Multiagent chemotherapy, notably mogamulizumab, is used for aggressive variantes.1,2 Chemotherapeutic agents used in ATL can be costly and associated with significant adverse effects. Imiquimod is an immunomodulator approved for actinic keratosis, primary superficial basal cell carcinoma, and genital warts. Off-label use has been efficacious in mycosis fungoides, lentigo maligna melanoma, HIV-negative Kaposi sarcoma, and primary cutaneous anaplastic large-cell lymphoma.3, 4, 5 We present a patient in whom nearly complete resolution of ATL was achieved with topical imiquimod therapy.