Reem Al Shabeeb, a 2021 graduate of The George Washington University School of Medicine and Health Sciences (SMHS), is one of the authors of the study, “The Infection Rate of Intralesional Triamcinolone and the Safety of Compounding in Dermatology for Intradermal and Subcutaneous Injection: A Retrospective Medical Record Review,” published in the Journal of the American Academy of Dermatology.
Al Shabeeb, along with Kelley Redbord, MD, associate clinical professor of dermatology in the Department of Dermatology at SMHS, Misty Eleryan, MD, a micrographic surgery and dermatologic oncology fellow at UCLA Health who completed her residency at SMHS, and researchers from Henry Ford Hospital in Detroit, Michigan, conducted a review of medical records to determine the rate of infection for intralesional triamcinolone compounded in-office. Intralesional injections of corticosteroids, such as triamcinolone, are performed directly into the skin. This procedure is typically used to treat inflammatory skin conditions, such as acne cysts, scar tissue, or a hair loss condition known as alopecia areata.
“Intralesional injections are standard in dermatology because they are safe, affordable, and can be done conveniently in the office,” Al Shabeeb said. “The problem is that in 2012 there was an outbreak of meningitis associated with contaminated intrathecal steroid injections, which has led to increased regulations for in-office compounding. However, there really isn’t a lot of safety data available to say intralesional corticosteroids are unsafe.”
Al Shabeeb and the team looked at patients who had received in-office intralesional corticosteroid injections, with a window of 30 days post-injection to see if infections had occurred. With the researchers at Henry Ford Hospital, they analyzed 4,370 intralesional triamcinolone injections, 2,780 of which were triamcinolone compounded with bacteriostatic saline. The team determined there were 11 suspected localized infection cases, or 0.25%, with four cases falling within the compounded triamcinolone group. Seven of the 11 possible infections took place after injection of a reported inflamed cyst.
“We didn’t find any hospitalizations or deaths related to these injections,” Dr. Redbord said. “These injections, compounded in-office for intralesional dermal or subcutaneous use, are safe when medical professionals use sterile equipment. There is no increased risk when you compare compounded and noncompounded triamcinolone.”
To access the study, which Practice Update named a “Story of the Week,” visit the Journal of the American Academy of Dermatology.
