Clinical Study on Hypopigmentation Induced by Intralesional Corticosteroid Injection

Shim, Woo Haing; Jwa, Seung Wook; Song, Margaret; Kim, Hoon Soo; Ko, Hyun Chang; Kim, Byung Soo; Kim, Moon Bum

Abstract

BACKGROUND
Several cases of hypopigmentation induced by intralesional corticosteroid injection have been reported. However, there is little information concerning the epidemiology and clinical characteristics of such cases.
OBJECTIVE
To describe the epidemiology and clinical characteristics of hypopigmentation induced by intralesional corticosteroid injection.
METHODS
A retrospective clinical study was performed on 22 patients with hypopigmentation induced by intralesional corticosteroid injection, during a period of January 2003 to December 2010. Investigated factors included sex, age, previous history of intralesional corticosteroid injection, clinical manifestations, treatment modalities and clinical course.
RESULTS
Of the 22 patients, 21 were female and 1 were male with the mean age of 34.3+/-17.5 (range 4~68) years old. Twelve patients were treated with corticosteroid injection for the treatment of musculoskeletal diseases, whereas, 10 patients for treatment of skin diseases. Eight patients were injected by dermatologists, 3 patients by orthopedists and 11 patients by doctors of unknown specialty. The mean number of the times of corticosteroid injection was 1.9. On the average, hypopigmentation occurred 4.2 months after corticosteroid injection. Upper extremities were most frequently affected, followed by the scalp, face, lower extremities and trunk. Hypopigmentation in most patients were localized and accompanied with skin depression and telangiectasia. There was complete resolution of hypopigmentation within 3.7 months, on average.
CONCLUSION
Intralesional injections of corticosteroid are performed not only as the treatment of various skin diseases, but also for the treatment of musculoskeletal diseases. Intralesional corticosteroid injection could cause hypopigmentation of the skin, and it could be confused with other skin diseases presented with hypopigmented patch. However, dermatologist could distinguish hypopigmentaion induced by intralesional corticosteroid injection from other skin diseases, such as vitiligo, by the presence of skin depression, telangiectasia and spontaneous resolution.