Hi. The US FDA recommends that Aldara (Imiquimod) be used with caution in patients with pre-existing autoimmune disease. It's not absolutely contraindicated for someone with an autoimmune problem, but Aldara has not been properly evaluated for these types of patients, so care should be taken when Aldara is used in these cases. The US FDA also does not officially approve its use for melanoma or pre-melanoma (lentigo maligna). Its use is approved for basal cell skin cancer and actinic keratosis, a precursor condition of squamous cell carcinoma of the skin. At present, the best evidence for the use of imiquimod for melanoma or lentigo maligna are only case reports. While the results of these studies are promising, only a few patients have been studied and the quality of evidence is weak. Common side effects to Aldara involve skin reactions in the area where it was applied. These include redness, swelling, blisters or ulcers, skin thickening, peeling, scabbing and crusting, itching, burning, and discoloration.