Cutaneous Adverse Effects of Beta-blockers: A Case of Psoriasis induced by Nebivolol

Nebivolol comes under the class of cardio selective Beta-blockers. Beta blockers are a very popular class of drugs used to treat both cardiovascular and non-cardiovascular diseases, including hypertension, ischaemic heart disease, arrhythmias, heart failure, hyperthyroidism, glaucoma, and anxiety disorders. Typically prescribed for high blood pressure, beta-blockers are among the drugs most commonly linked to psoriasis. Psoriasis is a complex, chronic, multifactorial, inflammatory disease that involves hyper-proliferation of the keratinocytes in the epidermis, with an increase in the epidermal cell turnover rate. This case report describes a 70 years old male with hypertrophic cardiomyopathy, Dyslipidemia, Coronary Artery Disease and systemic hypertension who developed psoriasis due to administration of nebivolol, a beta blocker used to manage HTN. The patient came with complaints of itchy erythematous scaly plaques with erosions over scalp, trunk and extremities for 1 month. Discontinuation of beta blockers such as nebivolol was advised. This case highlights our attention to the potential dermatologic adverse effects that may follow with a beta-blocker use, as well as proper reviewing of medical history for any allergic reactions and the optimization of drug therapy in order to avoid such drug-induced flares.