Ann Dermatol.  2019 Apr;31(2):217-220. 10.5021/ad.2019.31.2.217.

A Permanent Hair Loss in a Patient with Hypersensitivity to Intralesional Triamcinolone Injection

• Lee YI
• Lee M
• Lee S
• Kim DY

• KMID: 2439070
• DOI: http://doi.org/10.5021/ad.2019.31.2.217

Abstract

Despite multiple possible side effects, mesotherapy with a diverse mixture of unapproved products has been performed for the treatment of hair loss. In this case report, we present a rare case of permanent hair loss due to an allergic reaction from a mesotherapy mixture including triamcinolone acetonide. The patient showed a positive intradermal allergic skin test result for triamcinolone and therefore was diagnosed with scarring alopecia due to delayed type IV hypersensitivity to corticosteroid. This case study suggests that dermatologists should always be fully aware that both IgE-mediated and non-IgE-mediated hypersensitivity reactions from the corticosteroids as well as their mesotherapy excipients are possible in an effort to prevent irreversible adverse event from the mesotherapy.

Keyword

Alopecia; Delayed hypersensitivity; Intralesional injections; Mesotherapy; Triamcinolone acetonide

MeSH Terms

Adrenal Cortex Hormones
Alopecia
Cicatrix
Excipients
Hair*
Humans
Hypersensitivity*
Hypersensitivity, Delayed
Injections, Intralesional
Mesotherapy
Skin Tests
Triamcinolone Acetonide
Triamcinolone*
Adrenal Cortex Hormones
Excipients
Triamcinolone
Triamcinolone Acetonide

Figure

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  Fig. 1 Initial photographs of hypersensitivity reaction. Swelling on (A) face and (B) scalp developed after intralesional injection of the mesotherapy mixture.

• 

  Fig. 2 A permanent hair loss shown at each intralesional corticosteroid injection site 1 month after the injection.

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  Fig. 3 Intradermal allergic skin test results showed positive reaction to 10 mg/ml triamcinolone acetonide: A, 100,000:1 mixture of 2% lidocaine+epinephrine; B, 2:1 mixture of normal saline+NaHCO3; C, normal saline (0.9% sodium chloride); D, antibiotics (lincomycin); E, 8:1 mixture of normal saline+10 mg/ml triamcinolone acetonide; F, 5 mg/ml dexamethasone.

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