Intralesional corticosteroid injection as an effective treatment method for oral lesions: a meta-analysis

Abstract

Intralesional corticosteroid injection (ICSI) is known as one of the main methods used for treating a wide range of lesions. It also results in a high concentration of drugs at lesion sites, with minimal systemic absorption. Thus, this study aimed to provide a review of the intralesional corticosteroid injection (ICSI) indications in the treatment of oral lesions. To this end; relevant key words were searched in the databases of PubMed, Google Scholar, Scopus, ScienceDirect, and UpToDate in the present study. Accordingly, the results of a total number of 62 case reports or case series articles were used in this study and the positive therapeutic effects of intralesional corticosteroid injection (ICSI) in 23 common oral lesions were reported. The most common type of intralesional steroid in the treatment of oral lesions was triamcinolone. No significant difference was also observed in terms of pain in patients following the use of steroid alone or in combination with anesthetic agents; moreover, the reported side effects of this method were exceptionally rare and transient. It was concluded that the intralesional corticosteroid injection (ICSI) could be one of the effective therapeutic methods with no significant problems in many oral lesions such as inflammatory, immunologic, and vascular ones due to its higher therapeutic effects than other topical forms of steroids and fewer side effects than systemic corticosteroid.

Efficacy of Preemptive Dexamethasone versus Methylprednisolone in the Management of Postoperative Discomfort and Pain after Mandibular Third Molar Surgery: A Systematic Review and Meta-Analysis

“…However, complications associated with a single dose of corticosteroids are rare and have been reported in studies involving intralesional injection of corticosteroids. These include the complications such as pain, bleeding, and allergic reaction [ 38 ]. In the studies included in the analysis, none of them reported any significant complication which could be attributed to the single dose of corticosteroid.…”

Current Advances in Hypertrophic Scar and Keloid Management

“…61 Steroids have anti-inflammatory, antiproliferative, immunosuppressive, and vasoconstrictive properties which can help reduce pain and pruritus. 70,71 Steroids reduce collagen and glycosaminoglycan synthesis, inhibit fibroblast proliferation, and cause degeneration of collagen and fibroblasts. 3,72,73 Using intralesional corticosteroids allows for attainment of higher concentrations of steroid at the scar site with minimal systemic absorption.…”

“…75 Typically, systemic side effects are not seen since low doses are used; however, it has been reported that repeated dosing with steroid injection can be associated with hypertension, heart failure, uncontrolled diabetes, and bacterial and fungal infections. 71 Intralesional injections have also been associated with early effects such as bleeding, bruising, infection, impaired wound healing, sterile abscesses, and delayed effects such as cutaneous and subcutaneous lipoatrophy, leukoderma, telangiectasia, and localized or distant steroid acne. 71,76 5-Fluorouracil (5FU) is a pyrimidine analog that inhibits thymidylate synthase enzyme.…”

“…71 Intralesional injections have also been associated with early effects such as bleeding, bruising, infection, impaired wound healing, sterile abscesses, and delayed effects such as cutaneous and subcutaneous lipoatrophy, leukoderma, telangiectasia, and localized or distant steroid acne. 71,76 5-Fluorouracil (5FU) is a pyrimidine analog that inhibits thymidylate synthase enzyme. Its use as a therapy option in HTSs and keloids is based on the fact that it inhibits fibroblast proliferation, induces fibroblast apoptosis without necrosis, delays cell cycle progression, and inhibits TGF-β-induced collagen type I synthesis.…”