Linear Hypopigmentation and CutaneousAtrophy Following Intra – Articular SteroidInjections for de Quervain’s Tendonitis
May 2009 | Volume 8 | Issue 5 | Case Reports | 492 | Copyright © May 2009
Priya Venkatesan MD and William L. Fangman MD
Abstract
Intralesional and intra-articular corticosteroids are commonly used therapies in the fields of dermatology, orthopedic surgery and
rheumatology. The authors present the case of a 32-year-old female who received intra-articular corticosteroids for de Quervain’s
tendonitis and developed bilateral hypopigmented patches near the areas of injection. Unilateral linear extension of the hypopigmentation
was subsequently noted, presumably secondary to venous or lymphatic uptake of corticosteroid crystals. The patient complained
of temperature sensitivity and increased skin fragility affecting all of the hypopigmented areas. A biopsy was performed and
MART-1 immunostaining revealed intact melanocytes along the dermal-epidermal junction. The mechanism of corticosteroid-induced
hypopigmentation is not well understood, but this biopsy finding supports a decrease in melanocyte function rather than actual loss
of melanocytes as the cause of hypopigmentation.