Localized Immediate Type Hypersensitivity Reaction Following Intralesional Triamcinolone Acetonide into a Keloid

Corticosteroids are rare causes of immediate type hypersensitivity reactions. We report a rare case of immediate type hypersensitivity reaction following an intralesional injection of triamcinolone acetonide into a presternal keloid. He had itching in and around the keloid along with an erythematous rash around the keloid, which had started 4 hours after the injection and had lasted for the next 18 hours. He did not have any systemic symptoms of anaphylaxis. Intra-dermal test with 1:100 (concentration of 0.4 mg/ml) dilution of the same commercial preparation of triamcinolone acetonide (Tricort) showed a positive intra-dermal test reaction to Tricort (Tricort wheal size 12 mm, saline wheal size 4 mm).