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Intralesional Steroids: When and How to Inject?

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Hair and Scalp Treatments
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Abstract

Intralesional steroid (IL-S) injections have been used to treat a variety of dermatological and nondermatological diseases. In the treatment of alopecias, IL-S are an important therapeutic tool for many types of both scarring and nonscarring hair loss. This chapter covers practical topics such as the type and concentration of the steroid to be injected, indications, technique of injection, potential local and systemic adverse effects, and how to prevent them.

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References

  1. 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(5):363–70.

    Article  CAS  Google Scholar 

  2. Melo DF, Dutra TBS, Baggieri VMAC, Tortelly VD. Intralesional betamethasone as a therapeutic option for alopecia areata. An Bras Dermatol. 2018;93(2):311–2. https://doi.org/10.1590/abd1806-4841.20187423.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, et al. Alopecia areata: an appraisal of new treatment approaches and overview of current therapies. J Am Acad Dermatol. 2018;78(1):15–24. https://doi.org/10.1016/j.jaad.2017.04.1142.

    Article  PubMed  Google Scholar 

  4. Richards RN. Update on intralesional steroid: focus on dermatoses. J Cutan Med Surg. 2010;14(1):19–23.

    Article  CAS  Google Scholar 

  5. Pirmez R, Abraham LS, Duque-Estrada B, Damasco P, Farias DC, Kelly Y, et al. Trichoscopy of steroid-induced atrophy. Skin Appendage Disord. 2017;3(4):171–4. https://doi.org/10.1159/000471771.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ustuner P, Balevi A, Özdemir M. Best dilution of the best corticosteroid for intralesional injection in the treatment of localized alopecia areata in adults. J Dermatolog Treat. 2017;28(8):753–61. https://doi.org/10.1080/09546634.2017.1329497.

    Article  CAS  PubMed  Google Scholar 

  7. Jarratt MT, Spark RF, Arndt KA. The effects of intradermal steroids on the pituitary-adrenal axis and the skin. J Invest Dermatol. 1974;62(4):463–6.

    Article  CAS  Google Scholar 

  8. Pirmez R, Price VH, Cuzzi T, Trope BM. Acne keloidalis nuchae in renal transplant patients receiving tacrolimus and sirolimus. Australas J Dermatol. 2016;57(2):156–7. https://doi.org/10.1111/ajd.12271.

    Article  PubMed  Google Scholar 

  9. Porter D, Burton JL. A comparison of intra-lesional triamcinolone hexacetonide and triamcinolone acetonide in alopecia areata. Br J Dermatol. 1971;85(3):272–3.

    Article  CAS  Google Scholar 

  10. Shapiro J, Price VH. Hair regrowth. Therapeutic agents. Dermatol Clin. 1998;16(2):341–56.

    Article  CAS  Google Scholar 

  11. Kassim JM, Shipman AR, Szczecinska W, Siah TW, Lam M, Chalmers J, et al. How effective is intralesional injection of triamcinolone acetonide compared with topical treatments in inducing and maintaining hair growth in patients with alopecia areata? A critically appraised topic. Br J Dermatol. 2014;170(4):766–71. https://doi.org/10.1111/bjd.12863.

    Article  CAS  PubMed  Google Scholar 

  12. Donovan JC, Samrao A, Ruben BS, Price VH. Eyebrow regrowth in patients with frontal fibrosing alopecia treated with intralesional triamcinolone acetonide. Br J Dermatol. 2010;163(5):1142–4. https://doi.org/10.1111/j.1365-2133.2010.09994.x.

    Article  CAS  PubMed  Google Scholar 

  13. Chu TW, AlJasser M, Alharbi A, Abahussein O, McElwee K, Shapiro J. Benefit of different concentrations of intralesional triamcinolone acetonide in alopecia areata: an intrasubject pilot study. J Am Acad Dermatol. 2015;73(2):338–40. https://doi.org/10.1016/j.jaad.2015.04.049.

    Article  PubMed  Google Scholar 

  14. Triancilâ„¢ drug information: http://www.anvisa.gov.br/datavisa/fila_bula/frmVisualizarBula.asp?pNuTransacao=1001392014&pIdAnexo=1962779 (as on 25 Nov 2018).

  15. Narahari SR. Comparative efficacy of topical anthralin and intralesional triamcinolone in the treatment of alopecia areata. Indian J Dermatol Venereol Leprol. 1996;62:348–50. qtd in Kassim JM, Shipman AR, Szczecinska W, et al. How effective is intralesional injection of triamcinolone acetonide compared with topical treatments in inducing and maintaining hair growth in patients with alopecia areata? A Critically Appraised Topic. Br J Dermatol. 2014;170(4):766–71. https://doi.org/10.1111/bjd.12863.

    Article  CAS  PubMed  Google Scholar 

  16. Kumaresan M. Intralesional steroids for alopecia areata. Int J Trichology. 2010;2(1):63–5. https://doi.org/10.4103/0974-7753.66920.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Pirmez, R. (2020). Intralesional Steroids: When and How to Inject?. In: Tosti, A., Asz-Sigall, D., Pirmez, R. (eds) Hair and Scalp Treatments. Springer, Cham. https://doi.org/10.1007/978-3-030-21555-2_2

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  • DOI: https://doi.org/10.1007/978-3-030-21555-2_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21554-5

  • Online ISBN: 978-3-030-21555-2

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