Using a transcutaneous pneumatic injection (TPI) for intralesional injection (ILI) of triamcinolone can resolve lichen simplex chronicus (LSC) quickly and less painfully than other methods, according to study results published in the Journal of the American Academy of Dermatology.

The typical treatment for LSC involves topical antipruritic agents; however, these have high rates of treatment failure and complications due to the limited absorption of transepidermal drugs. A more effective treatment for LSC is the ILI of corticosteroids, but the injections are painful. In addition, the amount and depth of the drug injected may be inconsistent.

The researchers used a TPI device to perform ILI on LSC lesions that showed no therapeutic response after 1 month of treatment with topical steroids. They injected triamcinolone 0.4 mg/mL into the lesions at 2-cm intervals. The TPI device uses forced air to deliver drugs without needles and is much less painful than standard injections. Since the amount injected and the air pressure can be set on the TPI device,  the same amount of drug will be delivered at the same depth to every injection site.

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Only a few days post-treatment, participants showed improvements in their lesions. Within 1 month, lesions were completely resolved.

“The [TPI] device is more convenient to use and results in less pain and thus can be used as an alternative treatment tool for various dermatological conditions requiring ILI, as well as for cosmetic indications,” the researchers wrote.

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Jung HM, Eun SH, Lee JH, et al. Less painful and effective intralesional injection method for lichen simplex chronicus [published July 16, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.07.009