ADVERSE DRUG REACTION

REPORT
Clobetasol and Betamethasone
induced Acne and Melasma

Name:Jaya Nautiyal
Roll no. 53
 Patient initials
 Name-N
 Age-18
 Gender-Female
 Address- Dehradun
 Reg.No.-340896
 Chief complaint
 18 year old female N. ,resident of
Dehradun, visited the OPD of
Dermatology department of Govt.
Doon Medical College & Hospital on
31/12/2019 with chief complaints of-

 Brown patches on cheeks

 Acne
History of presenting
illness
 Patient was using topical Betnovate(plain)
for cosmetic purposes from last 1 month
which was self medicated. And also used
clobetasol by concerning to a near by
pharmacist.

 But four(4) days prior to visiting the OPD of

Dermatology she noticed brown patches on
cheeks and more acne eruption.
History of past illness
 No past surgical history.

 Thereis no history of
hypersensitive reaction.

 Thereis no history of similar

drug related allergy.
Adverse Drug Reaction
 After continuous use of the drug
the patient started developing
signs and symptoms.
 Patient was diagnosed with acne

and melesma.
 Patient develop brown patches on

cheeks with acne.

 Treatment of ADR
 Cap Acutret 20mg for 3D
 Tab Cetirizine for 5D
 Cap azithromycin 520mg (antibiotic)

1tab mon,tue,wed.
 Face moist cream 2-3 times a day
 clinroz-NC gel at night
Proposed mechanism of Action
 Betamethasone is a corticosteroid . It
induces melanogenesis by causing
hormonal fluctuations.
 Melanocytes responds to a wide variety of

chemical mediators.
 The effect of corticosteroids on the

synthesis of mediators like prostaglandin

and leukotriene responsible for effects on
melanogenesis.
Mechanism of clobetasol
 Topical steroid like clobetasol induce acne
formation as follows..

 These lead to synthesis of lipocotin which inhibit

enzyme phospholipase a2, which release
arachidonic acid from cell wall phopspholipids and
cause inflammation.

 Degradation of follicular epithelium, resulting in

extrusion of the follicular content.
WHO-UMC SCALE
According to WHO-UMC SCALE ,
adverse drug reaction for betnovate and
clobetasol is as follows
 Events or laboratory test abnormality, with
reasonable time relationship drug intake.
 Could also be explained by disease or other

drug.
 Response to withdrawal may be lacking or

unclear.
 Hence drug reaction is-possible
ADR FORM
 REFERENCES
 https://www.drugs.com/drug-class/topical-steroi
ds.html retrieved on 16/01/2019
.
 Book-Essentials of medical pharmacology by

K.D.Tripathi;8th edition; page no.895,896 retrieved

on 18/01/2019