Telmisartan-induced lichenoid drug eruption: a case report

Lichenoid drug eruption (LDE) is a rare adverse reaction to various medications, including antihypertensives like telmisartan. Early identification and withdrawal of the offending agent are key to management. A 52-year-old hypertensive male on telmisartan developed pruritic, violaceous lesions over the scalp and extremities, later spreading to the face, neck, and back, with oral involvement. Initial treatment offered partial relief. A diagnosis of telmisartan-induced lichenoid eruption was made, and the drug was replaced with amlodipine. Betamethasone mini-pulse therapy and azathioprine were initiated, leading to full resolution of lesions, leaving only post-inflammatory hyperpigmentation. Although uncommon, telmisartan can cause LDEs. Timely discontinuation and appropriate immunosuppressive therapy ensure favourable outcomes.