Mometasone and Tretinoin Induced Exfoliative Dermatitis

A 21-year-old female with severe acne developed exfoliative dermatitis after applying a cream containing mometasone furoate (0.025%), hydroquinone (2%), and tretinoin (0.025%) at night. Within a day, she experienced redness and skin peeling, which was classified as a probable adverse drug reaction (ADR) based on Naranjo’s, WHO-UMC, and Karch & Lasagna causality scales. The reaction was assessed as moderate, predictable, and preventable. Management included discontinuation of all medications and treatment with Prednisone 10 mg (1-0-1), Nevlon Cream (1-1-1) mixed with Fucibet Cream, and sunlight avoidance. This case highlights the risks associated with inappropriate corticosteroid and retinoid use in acne treatment and the importance of proper patient counselling.