Complications
Complications of intralesional corticosteroid therapy are common (reported in up to 63%) and include skin thinning, atrophy of the subdermal fat, telangiectasia, plaque formation, and pigmentary changes.[35]
Systemic corticosteroid adverse side effects are possible following intralesional injection and can lead to adrenal suppression and Cushing syndrome. One systematic review confirmed 18 cases of Cushing syndrome after intralesional triamcinolone administration; 80% of cases occurred in children, and most after administration of more than 40 mg of triamcinolone within a period of 1 month.[35]
Systemic hormone imbalance may develop, which can result in water retention and menstrual irregularities in susceptible women.[24]
The most common complication independent of treatment is infection, with reported rates ranging from 22.4% to 42.6% in observational studies.[95][96][97]
It usually begins as a small abscess within the scar tissue which spontaneously discharges, leaving a draining sinus.
Treatment involves topical wound care together with systemic antibiotics, if there is significant inflammation.
Scarring can cause psychological problems, and these may be compounded by management that results in aggravation of the scar such as surgical intervention without adjuvant treatment. A quality of life study in China reported increased rates of interpersonal relationship sensitivity, depression, and anxiety among patients with keloids.[94]
Guidelines recommend psychosocial care to support and improve the quality of life in patients with scars.[21]
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