Triamcinolone diacetate/acetonide

Intralesional injection of parenteral triamcinolone diacetate (Aristocort®) or acetonide (Kenalog®) are used to flatten uninfected, symptomatic acne cysts. It is also useful to treat hypertrophic scars, keloids, alopecia areata, lichen simplex chronicus, prurigo nodularis, and resistant plaques of psoriasis.

Adverse effects:

Atrophy - injection of therapeutic or supratherapeutic concentrations can lead to temporary dermal atrophy. This side effect is used for therapeutic gain in the treatment of keloids and hypertrophic scars.

Dosage:

• The standard vial concentration is diluted with xylocaine or saline to yield a final concentration of 5 mg/ml with 0.1 - 0.3 ml injected into an acne cyst, to the point of slight blanching of the overlying skin, or to a 1 cm² area of alopecia areata.
• Thick scars are commonly treated at 25 mg/ml, with 0.1 - 0.3 ml injected per cm² of scar.

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