A case of iatrogenic linear streaky hypopigmentation mimicking vitiligo

Abstract

Abstract Intralesional corticosteroid (I/L CS) is a frequently used therapy in dermatology that can seldom cause linear hypopigmentation. Very rarely this linear hypopigmentation may present as multiple streaks. The most widely accepted mechanism for this side effect is the lymphatic spread of CS suspension. Here, we report a case of multiple linear streaky hypopigmentation after I/L CS mimicking vitiligo along with a review of the literature and discuss measures to minimize this iatrogenic side effect. A 32-year-old lady developed the hypopigmented atrophic patch and multiple linear streaks of hypopigmentation over the right leg after receiving I/L CS. She responded dramatically to topical tacrolimus. To prevent this side effect, the lesion may be compressed for a few minutes after I/L CS injection to prevent its venolymphatic spread. This condition requires stoppage of further I/L CS and proper counseling and reassurance to the patient.