Comparing Immune Responses to Topical Imiquimod

Inclusion Criteria: * Individuals between 18 to 85 years of age * Patients with a diagnosis that will result in treatment with imiquimod as standard of care, specifically actinic keratosis Exclusion Criteria: * Younger than 18 years or older than 85 years. * History of hypersensitivity/ allergic reaction or adverse reaction to imiquimod * Individuals with a diagnostic biopsy and supportive histology of a cutaneous immune-mediated disease (e.g. psoriasis and mycosis fungoides, etc.) or diseases of the hematopoietic system, liver and the gastrointestinal tract (e.g. aplastic anemia, Crohn's disease, Ulcerative Colitis, Primary Sclerosing Cholangitis (PSC), Primary Biliary Cirrhosis, acute and chronic graft versus host disease (GVHD)). * Individuals with autoantibodies plus objective evidence of end organ damage related to a cutaneous immune-mediated disease (e.g. psoriasis and mycosis fungoides, etc.) or diseases of the hematopoietic system, liver and the gastrointestinal tract (e.g. aplastic anemia, Crohn's disease, Ulcerative Colitis, Primary Sclerosing Cholangitis (PSC), Primary Biliary Cirrhosis, acute and chronic graft versus host disease (GVHD)). * Individuals with a history of serious infection within the last 6 months. * Individuals with tuberculosis, HIV, or hepatitis B, or C. * Patients unable to provide consent * Incarcerated individuals