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Update on intralesional steroid: focus on dermatoses.
1Department of Medicine (Dermatology), North York General Hospital, Toronto, ON, Canada. revrichards@hotmail.com
Journal of Cutaneous Medicine and Surgery
|February 5, 2010
Summary
Intralesional steroids (ILS) are safe and effective for inflammatory skin conditions like psoriasis and dermatitis. Greater use of ILS is encouraged due to its high efficacy and cost-effectiveness.
Area of Science:
- Dermatology
- Pharmacology
- Inflammatory Skin Diseases
Background:
- Intralesional steroid (ILS) injections, primarily triamcinolone acetonide, are widely used for various dermatoses.
- Limited recent literature exists on ILS for inflammatory conditions like psoriasis and localized dermatitis since the 1960s.
Purpose of the Study:
- To clarify the established use of ILS in dermatology.
- To encourage the use of ILS in treating psoriasis and localized dermatitis.
Main Methods:
- Comprehensive literature search (1956-2008) for ILS use in skin diseases.
- Review of dermatology textbooks and product information.
- Data collection via questionnaires and discussions with 58 dermatologists.
Main Results:
- Divergent techniques and dosing noted among dermatologists using ILS.
- ILS at 2.5 mg/mL demonstrated high efficacy (nearly 100%) in small psoriasis plaques and localized dermatitis.
- Safe dosage escalation to 6-8 cc (15-20 mg) is possible for patients over 50 kg, with monitoring for adrenal suppression.
Conclusions:
- ILS at 2.5 mg/cc is a safe, economical, and effective treatment for inflammatory dermatoses.
- Increased utilization of ILS for psoriasis and localized dermatitis is recommended.
- Further well-designed clinical research is warranted to support evidence-based guidelines.
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