ILS
A skin lesion is abnormal damage or change in the tissues due to disease or trauma. There can be primary skin lesions and secondary skin lesions.
A primary skin lesion is present at birth or acquired during a person’s lifetime. A secondary lesion is developed from irritation or manipulation of the primary lesion.
Multiple skin conditions can lead to skin lesions such as acne, keloids, rash, boils, or some infection in the skin.
In an IntraLesional Steroid injection, triamcinolone acetonide, a corticosteroid, is injected into the lesion site or beneath the lesion to improve its appearance. A steroid injection into the affected area of the skin offers two advantages over topical and oral steroid treatment. First, it is often more successful in treating deep-seated diseases than a steroid cream or ointment, and second, it will only affect the skin in the region where it is applied. Rather than influencing the entire body like it does when it is injected, or in the case of a steroid pill (oral therapy), which is swallowed.
- Alopecia areata
- Keloid/hypertrophic scar
- Discoid lupus erythematosus
- Granuloma annulare
- Other granulomatous disorders such as cutaneous sarcoidosis or granuloma facial
- Localised psoriasis
- Hypertrophic lichen planus
- Lichen simplex chronicus (neurodermatitis)
- Necrobiosis lipoidica
- Acne cysts and inflamed epidermoid cysts
- Other localised inflammatory skin diseases.
Corticosteroids used intralesionally treat an inflammatory skin condition directly. Intralesional steroids, in contrast to topical steroids:
- Bypass the stratum corneum’s thick barrier
- Reduce your chances of developing epidermal atrophy (surface skin thinning)
- Deliver higher concentrations to the lesion proper.
How does it works
The site of infection is cleaned thoroughly with an antiseptic liquid.
Using a fine needle Triamcinolone is injected directly into the skin lesion. The injection should be intradermal rather than subcutaneous to avoid leaving a dent in the skin.
The initial dose per injection location will vary depending on the lesion being treated. Generally, 0.1–0.2 mL per square centimetre of the affected skin is injected. The total dose should not exceed 12 mL in most cases. It is recommended to do it every 4–8 weeks.
Frequently Asked Question's
Steroid injections are thought to be most beneficial within the first month of developing an alopecia areata patch. It is also possible that by controlling inflammation early on, the immune system is calmed and does not cause patches of hair loss elsewhere on the scalp, though this has not been proven. Steroid injections, on the other hand, can be administered at any time, according to your doctor’s recommendations, even one or two years after the presence of a patch.
No, there is no need for special preparation before the procedure.
The intra lesional steroid injection should not be injected at the location of an active skin infection (e.g., impetigo or herpes simplex).
If you have a known triamcinolone allergy, you should avoid using them.
Triamcinolone acetonide is classified as a systemic steroid when taken in large doses. to treat oral steroids like prednisone. Therefore, in patients with the following conditions, these should be avoided:
- Systemic steroids may destabilise psoriasis in those with extensive plaque psoriasis, pustular psoriasis, or erythrodermic psoriasis.
- Peptic ulcer illness that is active
- Diabetes uncontrolled, heart failure, or severe hypertension
- Psychosis or severe depression
Treatment is given every four weeks for up to 6 months. Some people need only one or two ILS treatments, while others require the full six treatments. The maximum number of treatments is three to four. Treatment is not extended beyond six treatments if there have been no results.
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Full strength corticosteroids (e.g., triamcinolone 10 mg/mL or 40 mg/mL) or diluted corticosteroids (e.g., triamcinolone 10 mg/mL or 40 mg/mL) can be used. Triamcinolone intralesional injections are commonly used in the following ways:
For a thick keloid scar, use 40 mg/ml.
10 mg/mL for a hypertrophic scar of moderate thickness
10 mg/ml into discoid lupus erythematosus or granuloma annulare.
5 mg/ml into normal-thickness skin in alopecia areata.
While the lesions are active, the injections may be repeated monthly for a few months.
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