Normal saline infiltration as a treatment of steroid injection induced tissue atrophy: A clinical study
Keywords:tissue atrophy, injectable steroid, normal saline
Introduction and Aim: Intramuscular steroid injection is a technique often used by unqualified village practitioners to control symptoms of a variety of disease processes. Such injudicious use of high dosages of steroids results in local side effects. Such side effects include occurrence of tissue atrophy at the site of injection. The treatment of such tissue atrophy includes filling up the gap with injection of autologous fat and other materials. However, these are expensive and require specialised set up. Normal saline infiltration into the atrophic area at varying intervals has been successfully tried by several authors in the past. The aim of the study was to find the efficiency and side effects of normal saline infiltration into acquired lipoatrophy areas as a method of treatment.
Material and Methods: After informed consent, normal saline was infiltrated into the defect till sufficient tumescence was obtained.
Results: Nine children were treated. Most of them had received steroid injections for exacerbation of childhood asthma. The defect had appeared shortly (2 to 4 months) after the last injection was received. The site of the defect was rounded and located on the deltoid region in the majority. Our success rate was 66%. The determination of the success rate of this technique and the factors contributing to the success of the technique requires more studies in this field.
Conclusion: Normal saline infiltration is a safe and effective way for treating steroid injection induced skin and tissue atrophy.
Sharma, R.K., Gupta, M., Rani, R. Delineating injectable triamcinolone-induced cutaneous atrophy and therapeutic options in 24 patients- A retrospective study. Indian Dermatol Online J 2022;13:199-206.
Goldman, L. Reactions Following Intralesional and sub-lesional injections of corticosteroids. JAMA. 1962;182(6):613-616.
Zalla, M.J., Winkelmann, R.K., Gluck, O.S. Involutional lipoatrophy: macrophage related involution of fat lobules. Dermatology. 1995;191:149153.
Shumaker, P.R., Rao, J., Goldman, M.P. Treatment of local, persistent cutaneous atrophy following corticosteroid injection with normal saline infiltration. Dermatol Surg. 2005;31:1340-1343.
Tiwary, P. K., Gurudiwan, P,, Chaudhary, R. Normal saline used in successful treatment of localised lipoatrophy in children. IP Indian J Clin Exp Dermatol 2016;2(4):174-176.
Margulies, S.L., Morris, A. Successful treatment of lipoatrophy with normal saline. JAAD Case Rep. 2015 Nov 25;1(6):415-417.
Fisherman, E.W., Feinberg, A.R., Feinberg, S.M. Local subcutaneous atrophy. JAMA 1962;179:971-972.
Schetman, D., Hambrick, G.W., Wilson, C.E. Cutaneous changes following local injection of triamcinolone. Arch Dermatol.1963;88:188-196.
Iuel, J., Kryger, J. Local cutaneous atrophy following corticosteroid injection. Acta Rheumatol Scand 1965;11:137-144.
Oikarinen, A, Autio, P. New aspects of the mechanism of corticosteroid-induced dermal atrophy. Clin Exp Dermatol. 1991;16(6):416-419.
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