Korean J Clin Neurophysiol.  2015 Dec;17(2):91-94. 10.14253/kjcn.2015.17.2.91.

Two Cases of Lipoatrophy after Local Corticosteroid Injection

Affiliations
  • 1Department of Neurology, Chungbuk National University College of Medicine, Cheongju, Korea. pnsdoctor@gmail.com

Abstract

The adverse effects of systemic steroid medications are well known, whereas those of local steroid injections are unclear even to clinicians. We report two cases of localized lipoatrophy and depigmentation following local steroid injection. Although the incidence of soft tissue atrophy after local steroid injection is rare, it will increase in proportion to the frequency of the procedure. All clinicians, even those who do not perform steroid injections, should be aware of the occurrence of this cosmetically disturbing adverse effect.

Keyword

Corticosteroid; Lipoatrophy; Triamcinolone

MeSH Terms

Atrophy
Incidence
Triamcinolone
Triamcinolone

Figure

  • Fig. 1. Appearance of steroid induced atrophy and hypopigmentation (arrow) of the right dorsum of hand after triamcinolone injection (A, B). Spontaneously improved skin lesion a year later (C, D).

  • Fig. 2. Appearance of steroid induced atrophy and hypopigmentation of the left medial foot after triamcinolone injection (A, B).


Reference

1.Cole BJ., Schumacher HR Jr. Injectable corticosteroids in modern practice. J Am Acad Orthop Surg. 2005. 13:37–46.
Article
2.Kumar N., Newman RJ. Complications of intra- and peri-articular steroid injections. Br J Gen Pract. 1999. 49:465–466.
3.Price R., Sinclair H., Heinrich I., Gibson T. Local injection treatment of tennis elbow-hydrocortisone, triamcinolone and lignocaine compared. Rheumatol. 1991. 30:39–44.
Article
4.Ahmed I. Post-injection involutional lipoatrophy: ultrastructural evidence for an activated macrophage phenotype and macrophage related involution of adipocytes. Am J Dermatopathol. 2006. 28:334–337.
5.Oishi Y., Fu ZW., Ohnuki Y., Kato H., Noguchi T. Molecular basis of the alteration in skin collagen metabolism in response to in vivo dexamethasone treatment: effects on the synthesis of collagen type I and III, collagenase, and tissue inhibitors of metalloproteinases. Br J Dermatol. 2002. 147:859–868.
Article
6.Schetman D., Hambrick GW Jr., Wilson CE. Cutaneous changes following local injection of triamcinolone. Arch Dermatol. 1963. 88:820–828.
Article
7.Firooz A., Tehranchi-Nia Z., Ahmed AR. Benefits and risks of intralesional corticosteroid injection in the treatment of dermatological diseases. Clin Exp Dermatol. 1995. 20:363–370.
Article
8.Say EA., Shields CL., Bianciotto C., Shields JA. Perilymphatic subcutaneous fat atrophy and cutaneous depigmentation after periocular triamcinolone acetonide injection in a child. J AAPOS. 2011. 15:107–108.
Article
9.Ryan TJ., Mortimer PS., Jones RL. Lymphatics of the skin. Neglected but important. Int J Dermatol. 1986. 25:411–419.
10.Chembolli L., Rai R., Srinivas CR. Depigmentation along lymphatic channels following intralesional corticosteroid injection. Indian J Dermatol. 2008. 53:210–211.
Article
11.Droste PJ., Ellis FD., Sondhi N., Helveston EM. Linear subcutaneous fat atrophy after corticosteroid injection of periocular hemangiomas. Am J Ophthalmol. 1988. 105:65–69.
Article
12.Venkatesan P., Fangman WL. Linear hypopigmentation and cutaneous atrophy following intra-articular steroid injections for de Quervain's tendonitis. J Drugs Dermatol. 2009. 8:492–493.
13.Reeves WG., Allen BR., Tattersall RB. Insulin-induced lipoatrophy: evidence for an immune pathogenesis. Br Med J. 1980. 280:1500–1503.
Article
Full Text Links
  • KJCN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr