Branch-shaped Cutaneous Hypopigmentation and Atrophy after Intralesional Triamcinolone Injection

Abstract

Cutaneous changes after local corticosteroid administration may include dermal atrophy, hyperpigmentation, alopecia, and hypopigmentation. Linear hypopigmentation and atrophy after intralesional injection of triamcinolone acetonide has been reported in the literature as a very rare side effect. A 30-year-old woman visited our dermatology department for a linear hypopigmented patch with atrophy from her left foot to the lower margin of the knee. The lesion developed after injection of an intralesional corticosteroid. The patient was diagnosed with linear hypopigmentation and atrophy secondary to the triamcinolone injection. (Ann Dermatol 23(1) 111∼114, 2011)

Linear extensions of hypopigmentation as a side effect of topical corticosteroid application

“…However, to the best of our knowledge, development of the hypopigmented linear streak apart from the original site of application has rarely been reported. Only a limited number of reports for linear atrophy and hypopigmentation after intradermal or intra‐articular injections with high concentrations of triamcinolone have been reported in the literature . As possible mechanisms for hypopigmentation at the primarily applied site, corticosteroid may alter melanocyte function by inhibiting prostaglandin or cytokine production in various epidermal cells, and significant decreases of melanin pigment in our case support these perspectives.…”

Hypopigmentation After Local Corticosteroid Injection for De Quervain Tenosynovitis

“…[7] Hypopigmentation generally begin to resolve without further treatment several months after the discontinuation of the steroid in the majority of cases. [2] However, the mechanism by which hypopigmentation occurs is not known. [9] The most widely accepted mechanism is the lymphatic spread of the corticosteroid suspension and resulting hypopigmentation or other complications of skin tissues.…”

“…[4] These injections direct a high-concentration of drug to the lesion site, thereby avoiding many of the potential side effects associated with systemic administration, such as hypothalamus-pituitary-adrenal axis suppression, endocrine changes, growth inhibition, allergic reactions, syncope, and blindness. [2,5] Cutaneous changes after local corticosteroid administration may include dermal atrophy, hyperpigmentation, alopecia, and hypopigmentation. [6] Hypopigmentation ， after intralesional injection of triamcinolone acetonide has been reported in the literature as a very rare side effect [3].…”

“…[3] The exact pathogenesis of hypopigmentation is also unknown. [2] In this article, we report a case who met hypopigmentation after local corticosteroid injection.…”

“…Cutaneous changes after local corticosteroid administration may include dermal atrophy, hyperpigmentation, alopecia, and hypopigmentation. [2] Hypopigmentation after intralesional injection of triamcinolone acetonide has been reported in the literature as a very rare side effect. [3] The exact pathogenesis of hypopigmentation is also unknown.…”