Topical/intralesional therapy

Glucocorticoids enjoy a large range of applications including topical ocular therapy, intralesional,... 

Promoting an Optimal Response to Therapy The glucocorticoids may be administered orally, IM, SC, IV, topically, or as an inhalant. The primary health care provider may also inject the drag into a joint (intra-articular), a lesion (intralesional), soft tissue, or bursa The dosage of the drug is individualized and based on the severity of the condition and the patient s response. 

The limited penetration of topical corticosteroids can be overcome in certain clinical circumstances by the intralesional injection of relatively insoluble corticosteroids, eg, triamcinolone acetonide, triamcinolone diacetate, triamcinolone hexacetonide, and betamethasone acetate-phosphate. When these agents are injected into the lesion, measurable amounts remain in place and are gradually released for 3-4 weeks. This form of therapy is often effective for the lesions listed in Table 61-2 that are generally unresponsive to topical corticosteroids. The dosage of the triamcinolone salts should be limited to 1 mg per treatment site, ie, 0.1 mL of 10 mg/mL suspension, to decrease the incidence of local atrophy (see below). 

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