Background: An adverse cutaneous drug reaction (ACDR) is an undesirable change in structure and function of the skin, its appendages, or mucous membranes due to drugs. Aims and Objectives: To study the demographic details, clinical patterns, mucocutaneous involvement, causality, and the offending drugs causing ACDR. Materials and Methods: In this observational study, we have seen 2,96,544 patients in the skin department at a rural-based tertiary health-care hospital, out of which 728 cases were diagnosed to have ACDR from a time span of April 2010 to March 2021. The causality assessment system WHO-UMC (World Health Organization Collaborating Centre for International Drug Monitoring, the Uppsala Monitoring Centre), the Naranjo probability scale, and Hartwigs score were calculated for patients. Results: Out of 728 cases, males were 371 (50.96%); most common age group was 21–30 years (25.13%). The most common presenting complaint was erythematous rash (21.29%). Antimicrobials ( n = 345, 47.39%) were the most common drug group. Most common mucosa involved was oral mucosa and most common pattern of reaction seen was maculopapular rash (25%) among these patients. In the causality assessment using WHO guidelines, there were 66 (9.1%) certain, 224 (30.83%) probable, and 436 (60%) possible cases. Naranjo score showed 73 (10%) definite cases, 255 (35%) probable cases, and 400 (55%) possible cases, while Hartwigs score showed level 2 in 122 (16.7%) cases and level 3 in 412 (56.7%) cases. Conclusion: Wide spectrum of drug reactions were observed in this study. Antimicrobials were the most common causative agents of ACDR.

Introduction: Facial pigmentary disorders are a group of heterogeneous disorders with clinical features of hyper- or hypopigmentation. They cause a great degree of psychosocial impact on patients’ quality of life due to their easy visibility. Aims and objectives: To find out different clinical and dermatoscopic patterns in facial melanosis. Materials and methods: Patients with hyperpigmentation or hypopigmentation over the face attending the skin OPD were recruited after taking their written consent in vernacular language. A detailed history was taken to collect demographic data. Clinical examination and dermatoscopy were done in all patients. Relevant investigations and biopsy were carried out as and when required. The descriptive statistics has been used to describe the quantitative data. Qualitative data were presented as frequency and percentage for clinical and dermatoscopic patterns. Results: The study included 180 patients having 20 different facial melanoses. Maximum number of patients (99; 55%) belonged to the age group of 19 to 40 years with female:male ratio of 1.72:1. The most common precipitating factor was sunlight in 66 (36.7%) patients followed by seasonal variation in 27 (15%) cases. Cheek was the most common site involved in 101 (56.1%) cases. Melasma was reported as the most common dermatosis including epidermal melasma 40 (22.2%), dermal melasma 26 (14.4%), and mixed melasma 4 (2.2%) cases followed by postinflammatory pigmentation (18; 10%), acanthosis nigricans (13; 7.2%), and vitiligo (11; 6.1%). In dermatoscopy, the most common pattern seen was reticuloglobular pattern in 68 (37.3%) cases, followed by black-brown globules in 47 (25.6%) cases. Conclusions: Melasma was reported as the most common cause of facial melanosis. The most common dermatoscopic pattern was the reticuloglobular pattern. The study is useful in understanding the different clinical and dermatoscopic patterns of facial melanosis, thereby help the physician to effectively manage the conditions and reduce the need of biopsy. Limitation: Histopathological correlation was not done.