A CASE STUDY ON SERTRALINE INDUCED PSORIASIS

This case report describes a female diabetic patient presenting with chronic dermatological manifestations. Mrs. X, with a history of poorly controlled diabetes mellitus (DM) and sleep disorders, reported persistent erythema, pruritus, and scaly patches on her thighs and hands. Physical examination revealed a thin body habitus and eczematous, scaly lesions on the extremities. Laboratory findings showed significant hyperglycemia (random blood sugar: 320 mg/dL). The patient’s medication regimen included metformin (500 mg), sertraline (85 mg), mirtazapine (7.5 mg), finasteride (0.5 mg), and an unspecified drug (Belavet, 8 mg), which may represent a reporting error. The clinical presentation raised differential diagnoses of diabetic dermopathy, fungal infections, or eczematous dermatitis, necessitating further diagnostic evaluation, such as skin scrapings for fungal microscopy or biopsy. Management focused on optimizing glycemic control, given the profound hyperglycemia, alongside empirical treatment with topical antifungals and emollients for symptom relief. A comprehensive medication review was recommended to assess potential drug- induced dermatological effects, particularly from psychotropic agents like sertraline and mirtazapine, which can contribute to dry skin and eczematous reactions. This case underscores the complex interplay between chronic hyperglycemia and skin pathology in diabetic patients. Poor glycemic control can impair skin barrier function, increase susceptibility to infections, and exacerbate inflammatory dermatoses. Additionally, the use of multiple medications, including psychotropics, may further complicate the clinical picture. Interdisciplinary collaboration among endocrinology, dermatology, and psychiatry is essential for holistic management.