Intralesional Therapies: Corticosteriods

Intralesional corticosteroid injections can be helpful for thick, localized, persistent lesions, such as psoriasis plaques or prurigo nodules. They are also used on the scalp and beard in the management of alopecia areata. Triamcinolone acetonide (Kenalog) is available in 10mg/mL and 40mg/mL concentrations and can be diluted with saline to the desired concentration to prevent atrophy. In general, approximately 0.1-0.2mL is injected per square centimeter of skin for a total dose not exceeding 1-2mL per session.  Often injections need to be repeated every 4-8 weeks.