Intralesional Triamcinolone Injection Consent Form

Intralesional Triamcinolone Injection Consent Form (#20)
Triamcinolone Treatment Information and Consent

Triamcinolone Treatment Information and Consent

Purpose

Triamcinolone is a synthetic glucocorticoid corticosteroid that has marked anti-inflammatory action. It is prepared in sterile aqueous suspension suitable for injecting directly into a lesion on or immediately below the skin to treat a dermal inflammatory process.

Indications

It is indicated for alopecia areata; inflammatory acne cysts; discoid lupus erythematosus; keloids and hypertrophic scars; inflammatory lesions of granuloma annulare, lichen planus, lichen simplex chronicus (neurodermatitis), psoriatic plaques, and other localized inflammatory skin conditions.

Potential Side Effects

I understand that triamcinolone injection can potentially cause early and/or delayed adverse effects such as:

  • Pain
  • Impaired wound healing
  • Increased hair growth
  • Bleeding
  • White or brown marks
  • Steroid acne
  • Infection
  • Telangiectasia
  • Skin thinning
  • Cutaneous and subcutaneous lipoatrophy (most common), appearing as skin indentations or dimples around the injection sites a few weeks after treatment

Although all reasonable efforts will be made to minimize the possibility of these potential complications, no guarantees can be made.

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