STUDYOFTHE EFFECT OF INTRALESIONAL INJECTION OFTRIAMCINOLONEACETONIDE ON ADRENAL FUNCTION
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The aim of intralesional steroid injection is to attain high concentration ofsteroids at the diseased site in the skin. Intralesional steroid injection is usedmainly for localized chronic lesionswhich do not respond to topical steroids and/or wherever prolonged systemic steroid therapy is undesirable. In this study the adrenal functions was studied following intralesional injection ofdiluted triamcinolone acetonide (10mg/ml) in doses of0.5ml inmanaging 10 caseswith patchy alopecia areata, lml inmanaging 10 cases with localized chronic eczema, and 2ml in managing 10 caseswith localized plaquepsoriasis. AH patients in this study had complete history taking, general and local examination at the first visit and also at the followup visits. Intalesional injection ofdiluted triamcinolone acetonidewas done using insulin syringe with a gauge of27-30 at the firstvisit, after 3weeks and 6 weeks. The hypothalamic pituitary-adrenal axis function was investigated by using longACTHstimulation test (long synacethen test) at 3 weeks and 6 weeks following intralesional injection of diluted triamcinolone acetonide by taking blood samples fromevery patient after intramuscular injection of p1"24 corticotrophin (tetracosatide hexacetate) adsorbed to zinc phosphate which is SUMMARYAND CONCLUSIONI ISUMMARYAND CONCLUSION^ available as Synathen depot, at 0, 1 hour, 4 hours, 8 hpurs^nd 24 hours both at 3 and 6 weeks for measuring serum cortisol level which is done using immulite cortisol kits. In the present study there was no statistically significant suppression ofthe hypothalamicpituitary-adrenal axis in all patients both at 3 and 6 weeks following intralesional injection ofdiluted triamcinolone acetonide with a maximum dose of 2 ml (eachml containing lOmg oftriamcinolone acetonide) andminimumdose of 0.5ml.