A Case Report on Clobetasol-Induced Purpura and Cellulitis

Abstract

Topical corticosteroids remain a cornerstone in the management of a wide array of dermatological conditions due to their anti-inflammatory, antiproliferative, and immunosuppressive properties. This article aims to present a clinically relevant case of clobetasol-induced purpura complicated by cellulitis, highlighting the need for judicious use of high-potency topical corticosteroids and reinforcing the importance of patient education regarding duration, dosage, and application sites. Clobetasol propionate, a super-potent topical corticosteroid, is commonly prescribed for chronic inflammatory dermatoses. However, prolonged use, especially without medical supervision, may result in severe adverse cutaneous effects such as purpura and secondary infections like cellulitis. We present the case of a 75-year-old female with a history of hypertension, who developed bilateral lower limb oedema and cellulitis over the right shoulder due to chronic unsupervised clobetasol application. Dermatology evaluation confirmed clobetasol-induced purpura and cellulitis. Prompt withdrawal of the corticosteroid and appropriate medical management led to full recovery. This case underscores the need for careful monitoring of potent topical corticosteroids and patient education. Also, this case underlines the importance of rational prescribing, short-term use, and adequate patient counselling regarding application, duration, and risks of potent corticosteroids.