Adverse Drug Reactions: Nitrosamine (and/or Telmisartan/HCT) Induced Nevus and Epidermal Scalp Cyst

This is a presenting case of a 57-year-old male with a longstanding history of primary arterial hypertension since the age of 13 years. He was placed on a treatment regimen of telmisartan/ hydrochlorothiazide (HTC) 80/12.5 mg oral half tablets daily (1/2-0-0) 10 years ago and has continued with this treatment to this day. The patient recently visited our clinic due to growing concerns of an unclear and at the same time haemorrhagic lesion on the scalp (Figure 1a). According to the anamnestic data, the scalp lesion was thought to appear roughly 9-10 years after starting therapy with telmisartan/HTC and continued to grow in size to about 15x8 mm (Figure 1a)