JAAD Game Changers: A prospective observational study evaluating hypothalamic-pituitary-adrenal axis alteration and efficacy of intramuscular triamcinolone acetonide for steroid-responsive dermatologic disease

Abstract

Capsule Summary:•Scant information on the administration, effectiveness, and safety of intramuscular triamcinolone acetonide (IM TAC), an important therapeutic alternative when topical corticosteroid treatment is impractical or ineffective, is available.•Thirty or 60 mg of IM TAC dosed 6 weeks apart on 2 occasions resulted in significant improvements in patient- and physician-reported clinical measures compared to baseline without causing iatrogenic Cushing syndrome or secondary adrenal insufficiency.•This series offers preliminary evidence of the efficacy and safety of IM TAC for a number of steroid-responsive dermatoses and provides a guide to dosing, frequency, and administration for dermatologist considering the use of IM TAC.How did this article change the practice of dermatology?A 30- or 60-mg intramuscular injection of triamcinolone does decrease total cortisol levels and results in significant improvement in patient- and physician-reported clinical measures compared with baseline.1 However, it does not appear to have significant clinical sequelae such as iatrogenic Cushing syndrome or secondary adrenal insufficiency in patients.