Topical corticosteroids induced hyper-pigmentation: a case report

Abstract

Hyper-pigmentation is a common skin condition in which increased melanin production results in darker patches of skin. Although hyper-pigmentation is harmless but still mostly people wish to get rid of them because of increasing craze of beautification in India. Topical corticosteroids (TC) application showed quick amelioration of post-inflammatory hyper-pigmentation patches. Prolonged and unsupervised use of TC leads to skin atrophy and reappearance of hyper-pigmentation patches. We present two cases of hyper-pigmentation induced by TC misuse. In case-1, a 20 year old female came to OPD with a complaint of hyper-pigmentation and itch sensation along with drug history of Betnovate cream for the last 2 years for acne treatment. On examination, she showed signs of hyper-pigmentation on cheeks. She was counselled to stop the further use of Betnovate cream and prescribed demelanizing agents along with sunscreen and emollients. The patches improved significantly with above management within 15 days. In case-2, a 33 year old female came to OPD with complaints of redness over whole face, increased facial hair growth and burning sensation along with drug history of using Betnovate cream for 2 years. On examination she showed signs of hyper-pigmentation and redness on cheeks, bruise and tearing of skin and increased facial hair growth. She was counselled to stop the further use of Betnovate cream. She was prescribed retinoic acid cream, sunscreen agents, anti-allergic tablets and emollient cream. The patches improved significantly with above management within 15 days.