Intralesional Therapy

Intralesional Therapy is the injection of a higher concentration of a drug directly into skin lesions without significant systemic absorption.

Most common type of intralesional therapy is intralesional steroid injection.

An intralesional steroid injection involves a corticosteroid such as triamcinolone acetonide injected directly into a lesion on or immediately below the skin.

What are intralesional steroids used for?

An intralesional steroid injection may be indicated for the following skin conditions:

  1. Alopecia areata
  2. Discoid lupus erythematosus
  3. Keloid/hypertrophic scar
  4. Granuloma annulare
  5. Other granulomatous disorders such as cutaneous sarcoidosis or granuloma faciale
  6. Hypertrophic lichen planus
  7. Lichen simplex chronicus (neurodermatitis)
  8. Localised psoriasis
  9. Necrobiosis lipoidica
  10. Acne cysts (see nodulocystic acne) and inflamed epidermoid cysts
  11. Small infantile haemangiomas
  12. Other localised inflammatory skin diseases.

What are the benefits of intralesional steroids?

Intralesional administration of corticosteroids treats a dermal inflammatory process directly. In contrast to topical steroids, intralesional steroids:

  1. Bypass the barrier of a thickened stratum corneum
  2. Reduce the chance of epidermal atrophy (surface skin thinning)
  3. Deliver higher concentrations to the site of the pathology.