Annals of Clinical Neurophysiology

The Korean Society of Clinical Neurophysiology (대한임상신경생리학회)
권호 표지
DOI QR코드

DOI QR Code

Two Cases of Lipoatrophy after Local Corticosteroid Injection

국소 겉질스테로이드 주사 후 발생한 지방위축증

  • Kim, Inha (Department of Neurology, Chungbuk National University College of Medicine) ;
  • Lee, Hye Lim (Department of Neurology, Chungbuk National University College of Medicine) ;
  • Lee, Sang-Soo (Department of Neurology, Chungbuk National University College of Medicine)
  • 김인하 (충북대학교 의과대학 신경과학교실) ;
  • 이혜림 (충북대학교 의과대학 신경과학교실) ;
  • 이상수 (충북대학교 의과대학 신경과학교실)
  • Received : 2015.07.31
  • Accepted : 2015.11.30
  • Published : 2015.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

The adverse effects of systemic steroid medications are well known, whereas those of local steroid injections are unclear even to clinicians. We report two cases of localized lipoatrophy and depigmentation following local steroid injection. Although the incidence of soft tissue atrophy after local steroid injection is rare, it will increase in proportion to the frequency of the procedure. All clinicians, even those who do not perform steroid injections, should be aware of the occurrence of this cosmetically disturbing adverse effect.

Keywords

References

  1. Cole BJ, Schumacher HR Jr. Injectable corticosteroids in modern practice. J Am Acad Orthop Surg 2005;13:37-46. https://doi.org/10.5435/00124635-200501000-00006
  2. Kumar N, Newman RJ. Complications of intra- and peri-articular steroid injections. Br J Gen Pract 1999;49:465-466.
  3. Price R, Sinclair H, Heinrich I, Gibson T. Local injection treatment of tennis elbow-hydrocortisone, triamcinolone and lignocaine compared. Rheumatol 1991;30:39-44. https://doi.org/10.1093/rheumatology/30.1.39
  4. Ahmed I. Post-injection involutional lipoatrophy: ultrastructural evidence for an activated macrophage phenotype and macrophage related involution of adipocytes. Am J Dermatopathol 2006;28:334-337. https://doi.org/10.1097/00000372-200608000-00008
  5. Oishi Y, Fu ZW, Ohnuki Y, Kato H, Noguchi T. Molecular basis of the alteration in skin collagen metabolism in response to in vivo dexamethasone treatment: effects on the synthesis of collagen type I and III, collagenase, and tissue inhibitors of metalloproteinases. Br J Dermatol 2002;147:859-868. https://doi.org/10.1046/j.1365-2133.2002.04949.x
  6. Schetman D, Hambrick GW Jr, Wilson CE. Cutaneous changes following local injection of triamcinolone. Arch Dermatol 1963;88:820-828. https://doi.org/10.1001/archderm.1963.01590240144024
  7. Firooz A, Tehranchi-Nia Z, Ahmed AR. Benefits and risks of intralesional corticosteroid injection in the treatment of dermatological diseases. Clin Exp Dermatol 1995;20:363-370. https://doi.org/10.1111/j.1365-2230.1995.tb01351.x
  8. Say EA, Shields CL, Bianciotto C, Shields JA. Perilymphatic subcutaneous fat atrophy and cutaneous depigmentation after periocular triamcinolone acetonide injection in a child. J AAPOS 2011;15:107-108. https://doi.org/10.1016/j.jaapos.2010.11.010
  9. Ryan TJ, Mortimer PS, Jones RL. Lymphatics of the skin. Neglected but important. Int J Dermatol 1986;25:411-419. https://doi.org/10.1111/j.1365-4362.1986.tb03443.x
  10. Chembolli L, Rai R, Srinivas CR. Depigmentation along lymphatic channels following intralesional corticosteroid injection. Indian J Dermatol 2008;53:210-211. https://doi.org/10.4103/0019-5154.44805
  11. Droste PJ, Ellis FD, Sondhi N, Helveston EM. Linear subcutaneous fat atrophy after corticosteroid injection of periocular hemangiomas. Am J Ophthalmol 1988;105:65-69. https://doi.org/10.1016/0002-9394(88)90122-5
  12. Venkatesan P, Fangman WL. Linear hypopigmentation and cutaneous atrophy following intra-articular steroid injections for de Quervain's tendonitis. J Drugs Dermatol 2009;8:492-493.
  13. Reeves WG, Allen BR, Tattersall RB. Insulin-induced lipoatrophy: evidence for an immune pathogenesis. Br Med J 1980;280:1500-1503. https://doi.org/10.1136/bmj.280.6230.1500