Clinical Pitfalls of Intralesional Corticosteroid Injection in Alopecia Areata by General Practitioners: A Retrospective Study
Daranporn Triwongwaranat MD1, Sumanas Bunyaratavej MD1, Pichanee Chaweekulrat MD1, Pacharee Iamtharachai BEd1, Chulaluk Komoltri DrPH2
Affiliation : 1 Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 2 Department of Research Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Intralesional corticosteroid injection is a treatment of choice in alopecia areata. To our knowledge, no study explored
and described pitfalls of this technique.
Objective : To clarify common pitfalls of intralesional corticosteroid injection technique in alopecia areata among Thai general
practitioners.
Materials and Methods : The present study was conducted by reviewing score sheets and questionnaires of 127 participants who
attended the annual short courses in practical dermatology for general practitioners organized by the Dermatological Society of
Thailand in 2013 and 2014. Before the workshop, preliminary practical examination was conducted. Participants were instructed
to perform intralesional corticosteroid injection in alopecia areata lesion using arti(cid:976)icial skin model and were scored by two
experienced dermatologists. Intralesional corticosteroid injection technique was categorized into four components (preparation
technique, medication selection, equipment selection, and injection technique).
Results : Common pitfalls among participants were inappropriate medication concentration (34.7%) and incorrect injection technique
(33.9%). Physicians with more experience in intralesional corticosteroid injection demonstrated more con(cid:976)idence (p-value <0.05).
Conclusion : Possible reasons for incorrect injection technique are limited dermatologic curriculum hour and insuf(cid:976)icient experience.
To achieve functional competency in intralesional corticosteroid injection technique, adequate training time and practical experiences
in medical school are required.
Keywords : Alopecia areata, General practitioner, Intralesional corticosteroid injection, Pitfall
