<\/span><\/h2>\nAn intralesional steroid injection involves a corticosteroid such as triamcinolone acetonide injected directly into an injury<\/span> on or just under the skin.<\/p>\nIn New Zealand, triamcinolone injection is marketed as Kenacort-A and is available in 2 strengths: 10 mg per mL (Kenacort-A 10) and 40 mg per mL (Kenacort-A 40). Triamcinolone Acetonide is marketed as Kenalog in the US. Betamethasone Injection is marketed as Celestone Chronodose (1 mL) and is not available in New Zealand.<\/p>\n
Shorter-acting corticosteroid preparations, such as dexamethasone or betamethasone acetate, are sometimes given in combination with triamcinolone.<\/p>\n
<\/span>What are intralesional steroids used for?<\/span><\/h2>\nAn intralesional steroid injection may be indicated for the following skin conditions:<\/p>\n
\n- Alopecia<\/span> areata<\/li>\n
- Discoid<\/span> lupus erythematosus<\/li>\n
- keloid\/hypertrophic<\/span> scar<\/span><\/li>\n
- Granuloma<\/span> cancel<\/li>\n
- Other granulomatous<\/span> disorders like cutaneous<\/span> sarcoidosis or facial granuloma\n<\/li>\n
- Hypertrophic lichen planus<\/li>\n
- Lichen simplex chronicus (neurodermatitis)<\/li>\n
- \nLocated<\/span> psoriasis\n<\/li>\n
- Necrobiosis<\/span> lipoidica<\/li>\n
- Acne cysts (see nodulocystic acne) and inflamed epidermoid cysts.\n<\/li>\n
- small infant hemangiomas<\/span>\n<\/li>\n
- Others located inflammatory<\/span> Skin diseases.<\/li>\n<\/ul>\n\n
<\/span>Hair regrowth after intralesional steroids in alopecia areata<\/span><\/h5>\n<\/section>\n\n\n
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Intralesional steroid injection for alopecia areata<\/p>\n<\/p><\/div>\n<\/section>\n
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<\/span>What are the benefits of intralesional steroids?<\/span><\/h2>\nIntralesional administration of corticosteroids treats a dermal<\/span> inflammatory process directly. In contrast with current<\/span> steroids, intralesional steroids:<\/p>\n\n- Avoid the barrier of a thickened stratum corneum<\/span>\n<\/li>\n
- Reduces the possibility of epidermal<\/span> atrophy<\/span> (thinning of surface skin)<\/li>\n
- Deliver higher concentrations to the site of pathology<\/span>.<\/li>\n<\/ul>\n
<\/span>Other Uses for Triamcinolone Acetonide Injection<\/span><\/h2>\nTriamcinolone injection is also sometimes used intramuscularly (instead of intralesional injection) systemically as an alternative to oral corticosteroids, for example for seasonal hay fever<\/span>or to treat a chronic<\/span> skin disorder like atopic<\/span> dermatitis<\/span> or lichen planus.<\/p>\nTypical intramuscular doses are 0.5\u20131 mg\/kg body weight (40\u201380 mg for a typical adult), which may be repeated every 30 days for 3\u20136 months.<\/p>\n
Triamcinolone injections can also be used in the treatment of tendinitis, arthritis<\/span>and synovitis.<\/p>\n<\/span>Which are the contraindications<\/span> to intralesional steroid injection?<\/span><\/h2>\nIntralesional steroids should not be injected into the site of active skin. infection<\/span> (for example, impetigo or herpes simplex).<\/p>\nThey should not be used if there is a known triamcinolone allergy<\/span>.<\/p>\nWhen large doses of triamcinolone acetonide are used as an alternative to oral steroids such as prednisone, they are considered systemic<\/span> Steroids should be avoided in patients with the following disorders:<\/p>\n\n- Active tuberculosis or systemic fungal infection\n<\/li>\n
- Extensive license plate<\/span> psoriasis, pustular<\/span> psoriasis or erythrodermic psoriasis: systemic steroids may destabilize psoriasis<\/li>\n
- Active peptic ulcer<\/span> disease<\/li>\n
- Uncontrolled diabetes, heart failure or severe hypertension<\/span>\n<\/li>\n
- Severe depression or psychosis<\/li>\n<\/ul>\n
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<\/span>How is the intralesional steroid administered?<\/span><\/h2>\nIntralesional triamcinolone is injected directly into the skin lesion using a fine needle after cleaning the injection site with alcohol or antiseptic. solution<\/span>. The injection must be intradermal<\/span>no subcutaneous<\/span>, to avoid causing dents in the skin.<\/p>\nThe initial dose per injection site will vary depending on the lesion to be treated. In general, 0.1\u20130.2 mL is injected per square centimeter of affected skin. The total dose should not normally exceed 1 to 2 ml per dose. It can be repeated every 4 to 8 weeks.<\/p>\n
The corticosteroid can be full strength (eg, triamcinolone 10 mg\/mL or 40 mg\/mL) or diluted with normal saline<\/span> or local anesthetic<\/span>. Typical regimens for intralesional triamcinolone injections include:<\/p>\n\n- 40mg\/ml for a thick keloid scar<\/li>\n
- 10 mg\/ml for a hypertrophic scar of moderate thickness\n<\/li>\n
- 10 mg\/ml in discoid lupus erythematosus or granuloma annulare\n<\/li>\n
- 5 mg\/mL in normal thickness skin associated with alopecia areata.<\/li>\n<\/ul>\n
The injections may be repeated monthly for a few months while the lesions are active.<\/p>\n\n<\/span>Intralesional steroid injection<\/span><\/h5>\n<\/section>\n\n\n
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Intralesional steroid injection<\/p>\n
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Intralesional steroid injection<\/p>\n<\/p><\/div>\n<\/section>\n
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<\/span>What side effects can occur at the site of an intralesional steroid injection?<\/span><\/h2>\nThe side effects and risks of intralesional triamcinolone can be divided into early and late effects.<\/p>\n
The first effects tend to be self-limited. They include:<\/p>\n