Citation: Dawadi Y, Nepal S. Hypopigmentation after intra articular steroid injection. J Clin Images Med Case Rep. 2024; 5(9): 3250.

Case presentation

A 33 years old female, without underlying medical comorbidity, presents with hypopigmentation over left lateral aspect of elbow for 3 weeks. She had a history of left lateral aspect elbow pain for 5 weeks duration and was diagnosed with tennis elbow. Patient was initially treated with oral Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) along with physiotherapy. Conservative treatment did not relieve the symptom so intraarticular steroid injection was injected. Triamcinolone acetate (40 mg) was injected in left elbow joint. 3 weeks later, hypopigmentation was noted (Figure 1). Systemic evaluation was normal. Full blood count, liver function and renal function tests were normal.

Description

Intraarticular steroid following failure of conservative management in tennis elbow is fairly common. The local adverse effects include calcification, atrophy, hypo and hyperpigmentation of skin. Hypopigmentation have been reported in few cases after Triamcinolone use following intraarticular steroid injection. It may be due to its high density and low solubility nature [1]. There is no specific treatment and usually resolves in a few months. Proper councelling of the patient regarding the side effect after intraarticular steroid should be done.

Figure 1: Hypopigmentation in Left elbow following intraarticular steroid injection.

References

1. Gupta A, Garg M, Johnson N, et al. Hypopigmentation after intra-articular corticosteroid injection. 2019; 12: 228921.