Cutaneous atrophy and alopecia after greater occipital nerve injection using triamcinolone.
Greater occipital nerve (GON) infiltration is widely used for the treatment of primary and secondary headache disorders mainly on the basis of open-label evidence, although recent double-blinded placebo-controlled trials have demonstrated its efficacy in cluster headache. The procedure is generally well tolerated although corticosteroid-related side effects, including Cushing's syndrome and local cutaneous changes, can occur. We report the occurrence of cutaneous atrophy and alopecia in 4 patients who underwent GON blockade with triamcinolone and lidocaine. Triamcinolone injection is associated with cutaneous atrophy, especially in superficial injection sites; therefore, alternative steroid preparations like methylprednisolone and betamethasone might be more appropriate for GON blockade.
Headache Group, Institute of Neurology and the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Giorgio
G
Lambru
Susie
S
Lagrata
Manjit S
MS
Matharu
D000279:Administration, Cutaneous; D000328:Adult; D000505:Alopecia / Q000139:chemically induced* / Q000175:diagnosis*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects; D001284:Atrophy / Q000139:chemically induced / Q000175:diagnosis; D001340:Autonomic Nerve Block / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013127:Spinal Nerves / Q000187:drug effects*; D014221:Triamcinolone / Q000008:administration & dosage / Q000009:adverse effects*
D000893:Anti-Inflammatory Agents; D014221:Triamcinolone