Successful treatment of lipoatrophy with normal saline

INTRODUCTION We present a case of lipoatrophy treated successfully with intralesional normal saline injections. Localized lipodystrophy, or lipoatrophy, presents as focal loss of subcutaneous fat with variable overlying skin changes and depth depending on the cause. Lipoatrophy could result from both oral and local intralesional corticosteroid use, with the buttocks and proximal extremities being the most commonly affected sites with oral use. Minimal literature exists about corticosteroid-induced lipoatrophy. Localized reactions to injected corticosteroids are thought to occur in less than 0.5% of cases, which primarily include hemorrhage, atrophy, secondary infection, changes in pigment, hypersensitivity reactions, and panniculitis. The observed lipoatrophy typically begins 2 to 3 months after injection and can resolve spontaneously. Here we report a case of acquired localized lipodystrophy, which results mostly in cosmetic concerns but has limited treatment options to offer patients. We describe the technique for intralesional saline injections to assist clinicians in use of this treatment. Success of this technique has been previously described, and our case report confirms this previous report but uses different time intervals between injections.