BENEFITS AND RISKS OF INTRALESIONAL CORTICOSTEROID INJECTION IN THE TREATMENT OF DERMATOLOGICAL DISEASES

Intralesional corticosteroid (CS) injections have been used to treat a variety of dermatological and non-dermatological diseases with variab le results. The purpose of the injection is to attain a high concentra tion of the drug at the diseased site, with minimal systemic absorptio n. Several CS preparations are available for intralesional injection, although triamcinolone derivatives have gained the widest usage in der matology. The dose and the interval between injections depend on the t ype, size and severity of the lesion as well as the response to the pr evious injections. The most critical issue in the efficacy and also in the development of complications of the injections, is the method of injection. Several local and systemic side-effects have been reported following intralesional injections, but most of them are rare or accep table. Thus intralesional CS injection is an integral part of the clin ical practice of dermatology. Since their introduction in 1951,(1) int ralesional CS injections have become an integral part of clinical prac tice in dermatology. They are used alone or in combination with other therapeutic modalities in the treatment of many skin diseases. The pur pose of the injection is to attain a high local concentration of the C S at the diseased site, without significant systemic absorption, thus avoiding the numerous side-effects associated with systemic administra tion. Intralesional CS injection may be a valuable therapeutic modalit y in situations where topical CS are not suitable for use, either beca use of low potency and inefficient epidermal barrier penetration or in clinical conditions associated with epidermal atrophy.