Intralesional corticosteroid injection as an effective treatment method for oral lesions: a meta-analysis

Intralesional corticosteroid injection (ICSI) is known as one of the main methods used for treating a wide range of lesions. It also results in a high concentration of drugs at lesion sites, with minimal systemic absorption. Thus, this study aimed to provide a review of the intralesional corticosteroid injection (ICSI) indications in the treatment of oral lesions. To this end; relevant key words were searched in the databases of PubMed, Google Scholar, Scopus, ScienceDirect, and UpToDate in the present study. Accordingly, the results of a total number of 62 case reports or case series articles were used in this study and the positive therapeutic effects of intralesional corticosteroid injection (ICSI) in 23 common oral lesions were reported. The most common type of intralesional steroid in the treatment of oral lesions was triamcinolone. No significant difference was also observed in terms of pain in patients following the use of steroid alone or in combination with anesthetic agents; moreover, the reported side effects of this method were exceptionally rare and transient. It was concluded that the intralesional corticosteroid injection (ICSI) could be one of the effective therapeutic methods with no significant problems in many oral lesions such as inflammatory, immunologic, and vascular ones due to its higher therapeutic effects than other topical forms of steroids and fewer side effects than systemic corticosteroid.

Unusual presentation of Erythema Elevatum Diutinum mimicking a giant wart on the heels of a Filipino male : A case report

@#Erythema elevatum diutinum (EED) is a rare condition believed to be a form of chronic recurrent leukocytoclastic vasculitis possibly secondary to vascular immune complex deposition. The disease is characterized by symmetrical, red, brownish-purple, and yellow papules, plaques, and nodules distributed mainly over the extensor surfaces of the extremities. We report a 61-year-old male with an atypical presentation of such disease as a giant warty lesion on the heels. Histologically, a spectrum from leukocytoclastic vasculitis to vessel occlusion and dermal fibrosis is seen in EED. These histological findings were present in the histopathological reading of the patient which established its diagnosis and further ruled out verruca vulgaris. The disease is associated with many disease entities, which include human immunodeficiency virus, malignant conditions, chronic infection, and autoimmune and connective tissue disorders. None of these conditions was present in the patient as manifested in the history, physical, and laboratory examinations. However, the patient has a low hemoglobin and a G6PD deficiency which makes him a bad candidate for dapsone therapy which is the main treatment for EED. Tetracycline, niacinamide and plain vaseline + salicylic acid were given initially for 4 weeks but no improvement was noticed. It was then shifted to 10mg intralesional corticosteroid and urea paste 40%. Niacinamide still was given. There was a marked thinning of the lesions. The medications were continued and were slowly tapered. More improvement of the lesions was observed.

Pilot Study of the Efficacy of 578 nm Copper Bromide Laser Combined with Intralesional Corticosteroid Injection for Treatment of Keloids and Hypertrophic Scars

BACKGROUND: Treatments including intralesional corticosteroid injection, pressure therapy, cryotherapy, and various laser therapies have had limited success for keloids and hypertrophic scars. OBJECTIVE: This trial evaluated the efficacy of a combination of 578 nm copper bromide laser and the more traditional intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with respect to scar color. METHODS: Keloids or hypertrophic scars of 12 Korean patients were treated five times by the combined treatment at 4-week intervals. Clinical improvement was assessed by the physicians' global assessment (PGA) comparing pre- and post-treatment photographs, as well as 4 weeks after the last treatment. Erythema intensity was quantified using a mexameter. RESULTS: Most scars showed significant clinical improvement in PGA and decreased erythema intensity after 5 treatments. All patients showed improvements in symptoms like pruritus. CONCLUSION: The combined treatment is effective for keloids and hypertrophic scars, especially when the telangiectatic portion of the scars is prominent. The adjunctive use of 578 nm copper bromide laser decreased the telangiectatic side effects of an intralesional corticosteroid injection by reducing the vascular components of scars.

Subcutaneous Sarcoidosis with Plantar Involvement

Sarcoidosis is a multisystem granulomatous disorder of an unknown etiology. Subcutaneous sarcoidosis is a rare manifestation of sarcoidosis, and plantar involvement is extremely rare and there is only one such case report in the medical literature. Herein we present an interesting case of a patient who was diagnosed as having subcutaneous sarcoidosis at a plantar localization because plantar involvement is extremely rare and also because of the successful outcome after performing intralesional corticosteroid therapy.

Optimal method of intralesional corticosteroid injection in the treatment of alopecia areata / 대한피부과학회지

Intralesional injection of adrenal corticosteroids has widely teen used in the treatment of alopecia areata. But the concentration of the drug and the intrval of the injection are greatly different among the physicians practicing the method. The author evaluated the therapeutie results and untoward effects of the intralesional injetions using two different concentrations on the same lesion devided into two or on the two simultaneousely occurred lesions in each patient, to make exact comparsion of the different concentrations in total 24 patients. Intralesional injections with triamcinolone acetonide 5mg/m a 2 week interval showed appreciable hair regrowing in 4 weeks in 62.5% while 1mg/ml of the drug at equal interval showed appreciable hair regrowing in 6 weeks in 66.7%. But, in the group of 5mg/ml, 16.7% of the lesions showed considerable delay of the hair growing because of the atropy of the skin and hair follicle while no such delay was found in the group 1mg/ml. With the above data, tlie best result would be expected by th concentration between 1mg/ml and 5mg/ml in case of triarncinolone acetonide intralesional injection at 2 week intervals,

Treatment of Congenital Hemangiomata with Intralesional Corticosteroid / 대한피부과학회지

Sixteen cases of congenital hemangiomata were treated with intralesional corticosteroid injectinn and followed up for 3 to 48 months. They consisted of 9 cases of strawberry hemangiomata with soft consistency, 4 cases of strawbery hemangiomata with firm consistency and 3 cases of cavernous hemangiomata. The results were as follows : 1) All the soft strawberry hemangiomata showed excellent response with marked shrinkage by single treatment. 2) The firm strawberry hemangiomata showed poor response with visible shrinkage after five times treatment, in average. 3) Among three cases of cavernous hemangiomata, one case with large palpable blood vessels in the lesion showed poor response, and two cases without palpable blood vessels in the lesion showed good response. 4) Temporary atrophy and pallor of the skin color were noticed in about half of the cases. Considering the concern of the patients parents, course of the hemangiomata., and the simplicity and effects of the treatment, this therapeutic method is regarded useful in the management of congenital hemangiomata, especially in soft st r awberry hemangiomata.