From the FDA Drug Label
INDICATIONS & USAGE: Triamcinolone cream is indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses.
The FDA drug label does not answer the question.
From the Research
Kenalog (triamcinolone acetonide) injections can be used to treat nummular eczema, particularly for stubborn, localized lesions that don't respond to topical treatments. These intralesional injections typically use concentrations of 2.5-10 mg/ml, with the amount varying based on the size and number of lesions. The medication is injected directly into the affected skin areas, with effects lasting several weeks to months. However, this approach is generally reserved for severe or resistant cases due to potential side effects, such as skin thinning (atrophy), hypopigmentation, telangiectasia (visible blood vessels), and systemic absorption with repeated use, as noted in a case report of granulomatous reaction to intralesional Kenalog injection 1.
Key Considerations
- Kenalog works by suppressing inflammation and immune responses in the skin, reducing the itching, redness, and scaling characteristic of nummular eczema.
- Most dermatologists prefer to try topical corticosteroids, topical calcineurin inhibitors, and proper skin care before moving to injections, as outlined in a review of nummular eczema treatment 2.
- If multiple lesions are present, systemic treatments might be more appropriate than multiple injections, considering the effectiveness of treatments like dupilumab for nummular eczema phenotype of atopic dermatitis in adults 3.
- Recent studies also suggest that low-dose intralesional injection of 5-fluorouracil and triamcinolone can reduce tissue resident memory T cells in chronic eczema, offering an alternative approach for treatment 4.
Treatment Approach
Given the potential benefits and risks, the decision to use Kenalog injections for nummular eczema should be made on a case-by-case basis, considering the severity of the condition, the presence of resistant lesions, and the patient's overall health status. It's also important to note that while Kenalog injections can be effective, they are not without side effects, and other treatment options, including topical treatments and systemic therapies, should be considered and discussed with the patient, as seen in the use of intralesional injection of triamcinolone acetonide for subcutaneous lipoma 5.