B.

1 Injeksi Kortikosteroid Intralesi

I. Definisi
Injeksi kortikosteroid intralesi adalah tindakan injeksi kortikosteroid secara langsung ke
dalam lesi.1 Injeksi kortikosteroid intralesi merupakan suatu metode invasif minimal.2

II. Indikasi3-6 (1A)

1. Keloid
2. Skar hipertrofik
3. Alopesia areata
4. Akne nodular
5. Akne nekrotikans
6. Hemangioma infantil (kecil, terlokalisasi)
7. Prurigo nodularis
8. Nodul hidradenitis supuratif

Indikasi lain7,8 (2B)

1. Liken simpleks kronikus
2. Granuloma anulare
3. Psoriasis kuku
4. Liken planus kuku
5. Liken amiloidosis

III. Kontraindikasi6
1. Terdapat infeksi lokal
2. Infeksi jamur sistemik
3. Hipersensitifitas terhadap steroid
4. Pasien tidak dapat menerima potensi atrofi kulit dan hipopigmentasi sebagai efek
samping.

IV. Efek Samping3,9,10

1. Lokal
 Nyeri
 Atrofi
 Infeksi
 Ulserasi
 Teleangiektasis
 Hipopigmentasi atau hiperpigmentasi

2. Sistemik
 Supresi adrenal
 Hipersensitifitas
V. Persiapan3,4,6,11-14 (1A)
Alat dan Bahan
1. Disposable syringe 1cc
2. Sarung tangan
3. Sediaan kortikosteroid injeksi (triamsinolon asetonid)
4. Alcohol swab
5. Kasa steril

Pasien
1. Informed consent
2. Dokumentasi pasien sebelum tindakan

VI. Prosedur Tindakan3,4,6,11-14

1. Tentukan dosis dan lokasi tempat injeksi sesuai indikasi
2. Tindakan aseptik dengan antiseptik
3. Dilakukan injeksi kortikosteroid intralesi sesuai indikasi
4. Apabila diperlukan, tindakan dapat diulang sesuai indikasi

VII. Kepustakaan
1. Deshmukh NS, Belgaumkar VA, Mhaske CB, Doshi BR. Intralesional drug therapy in
dermatology. Indian J Dermatol Venereol Leprol. 2017;83(1):127.
2. Ingram J, Collier F, Brown D, Burton T, Burton J, Chin M, et al. British Association of
Dermatologists guidelines for the management of hidradenitis suppurativa (acne inversa) 2018.
Br J Dermatol. 2019;180(5):1009-17.
3. Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, dkk, penyunting.
Fitzpatrick's Dermatology. Edisi ke-9. New-York: McGraw-Hill; 2019. h. 1409, 1539, 1520,
2574, 2058
4. Otberg N, Shapiro J. Cicatricial Alopecias. In: Kang S, Amagai M, Bruckner AL, Enk AH,
Margolis DJ, McMichael AJ, dkk, penyunting. Fitzpatrick's Dermatology. Edisi ke-9. New
York: McGraw-Hill; 2019. h. 1531.
5. Riis PT, Boer J, Prens EP, Saunte DM, Deckers IE, Emtestam L, et al. Intralesional
triamcinolone for flares of hidradenitis suppurativa (HS): a case series. J Am Acad Dermatol.
2016;75(6):1151-5.
7. Jung HM, Eun SH, Lee JH, Kim GM, Bae JM. Less painful and effective intralesional in jection
method for lichen simplex chronicus. J Am Acad Dermatol. 2018; 79(6):e105-106
8. McClanahan DR, English Therapeutics for adult nail psoriasis and nail lichen planus: A guide
for clinicians. J Am J Clin Dermatol. 2018;19(4):559-54.
9. Bjorklund KA, Fernandez Faith E. Branching hypopigmentation following intralesional
corticosteroid injection: Case report and review of the literature. Pediatr Dermatol.
2020;37(1):235-6.
10. Singh SVJ, Bachaspatimayum R, Akham SD, Sanjenbam RD. Intralesional steroid induced
hypopigmentation-a case report. Int J Sci Reports. 2017;3(4):108-9.
11. Panayi AC, Reitblat C, Orgill DP. Wound Healing and Scarring. Total Scar Management:
Springer; 2020. p.3-16.
12. Ahsan MQ, Sikder MAU, Khondker L. Efficacy of combination of intralesional corticosteroid
injection and cryotherapy versus intralesional corticosteroid injection alone in patients of
keloid. J Pakistan Assoc Dermatol. 2019;28(4):474-81.
13. Block L, Gosain A, King TW. Emerging therapies for scar prevention. Advances in wound
care. 2015;4(10):607-14.
14. Otberg N, Shapiro J. Alopecia Areata. Kang S, Amagai M, Bruckner AL, Enk AH, Margolis
DJ, McMichael AJ, et al., eds. Fitzpatrick's Dermatology. 9th ed. New-York: McGraw-Hill;
2019. p. 1520.