Uncommon Complication of a Common Therapy: Sterile Abscess After Triamcinolone Injection for Acne

Intralesional triamcinolone acetonide has been used as a common treatment modality for nodulocystic acne and can induce a significant reduction in the acne nodules owing to its anti-inflammatory effect. Intralesional steroids have been associated with potential adverse events like erythema, telangiectasias, secondary infections, hypersensitivity reactions, panniculitis, hypopigmentation, atrophy, and rarely Cushing syndrome. However, improper administration may lead to rare but significant complications like sterile abscess formation and risk of facial deformity. Inadvertent injection of high concentration or amount, wrong site, and multiple doses can lead to these localised or systemic side effects. As acne is a common skin condition affecting the adolescent age group, the possibility of such localised complications, especially a sterile abscess, cannot be ignored. This report documents an unusual presentation of a subcutaneous cystic collection following intralesional steroid injection for acne.