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Journal of Clinical Images and Medical Case Reports

ISSN 2766-7820
Clinical Image - Open Access, Volume 5

Inadvertent use of topical clobetasol leads to skin hypopigmentation: A clinical image

Priyanka Giri1*; Ajit Kumar Pradhan2; Prasanta Kumar Sahoo3; Santosh Kumar Sahu2

1Ayurvedic Medical Officer, Government Ayurvedic Hospital, Bhubaneswar, India.

2Department of AYUSH, All India Institute of Medical Sciences, Bhubaneswar, India.

3Department of AYUSH, Senior Medical Officer and H.O.D, All India Institute of Medical Sciences, Bhubaneswar, India.

*Corresponding Author : Priyanka Giri
Ayurvedic Medical Officer, Government Ayurvedic Hospital, Bhubaneswar, India. Tel: 91-891-738-8713;
Email: [email protected]

Received : Apr 24, 2024

Accepted : May 14, 2024

Published : May 21, 2024

Archived : www.jcimcr.org

Copyright : © Giri P (2024).

Keywords: Clobetasol; Topical steroids; Nummular dermatitis; Hypopigmentation.

Citation: Giri P, Pradhan AK, Sahoo PK, Sahu SK. Inadvertent use of topical clobetasol leads to skin hypopigmentation: A clinical image. J Clin Images Med Case Rep. 2024; 5(5): 3064

Description

An 18-year-old male presented to our outpatient department with a complaint of hypopigmented skin lesions with well-defined margins and peripheral inflammatory skin at the volar surface of the bilateral wrist and fingers symmetrically without peripheral skin inflammation for one month (Figures 1 and 2). Before three months, he suffered from multiple coin-shaped lesions with severe itching at the volar surface of the bilateral wrist; he consulted a dermatology clinic, was diagnosed with nummular dermatitis, and continued tablet levocetirizine 5mg once daily in the evening for one month and applied topical clobetasol propionate cream 0.05% upto two months. After two months of continued medicine, he is facing the present situation. He revisited the same dermatology clinic and stopped the topical clobetasol application. He came to our outpatient department for consultation. He has no history of diabetes, hypertension, hypo or hyperthyroidism, or autoimmune diseases. He is a student, non-alcoholic, and non-smoker, and has no family history.

Clobetasol is a class I superpotent topical corticosteroid that alleviates the inflammation and pruritus in nummular dermatitis [1]. United States Food and Drug Administration (USFDA)restricted the use of clobetasol to not more than two weeks [2]. Prolonged use may cause skin atrophy, photosensitivity, steroid acne, hypopigmentation, and Cushing-like syndrome [3].

Figure 1: Hypopigmented skin lesions with well-defined margins and peripheral inflammatory skin at the volar surface of the bilateral wrist.

Figure 2: Hypopigmented skin lesions with well-defined margins without peripheral skin inflammation on fingers symmetrically.

Declarations

Ethical approval: Written consent was obtained from the patient.

Funding: No funding has been received for this study.

Conflict of interest: Nil.

References

  1. Gabros S, Nessel TA, Zito PM. Topical Corticosteroids. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. https://www.ncbi.nlm.nih.gov/books/NBK532940/.
  2. Jhaj R, Asati DP, Chaudhary D, Sadasivam B. Topical steroid containing combinations: Burden of adverse effects and why the recent regulatory action may not be enough. Indian J Pharmacol. 2021; 53(5): 371-376. doi: 10.4103/ijp.IJP_728_19. PMID: 34854405; PMCID: PMC8641741.
  3. Dhar S, Seth J, Parikh D. Systemic side-effects of topical corticosteroids. Indian J Dermatol. 2014; 59(5): 460-4. doi: 10.4103/0019-5154.139874. PMID: 25284850; PMCID: PMC4171913.