Immediately after treatment:
- Most patients experience mild to moderate pain at the injection site after treatment. Sometimes, this pain can last up to 7 days.
- No special dressings are necessary after intralesional treatment with cytotoxic drugs.
Days and weeks after treatment:
- Some patients develop purple/red discolored spots on the skin (also known as purpura or “blood spots”) after treatment. These spots are due to mild bleeding under the skin and will gradually disappear over a few days or weeks.
- Additionally, some patients develop shallow open sores at the treatment site, sometimes with crusting. These sores which may appear in the first few days after treatment and may last up to 2-3 weeks. Your doctor may prescribe a topical antibiotic to treat these sores.
- Some patients experience skin darkening (hyperpigmentation) after intralesional treatment with cytotoxic drugs. This side effect will gradually disappear within 2 months to one year.
- Skin thinning (atrophy) is another potential long-term side effect and may take longer (1 year or more) to disappear, and in some cases may even be permanent. Dan: The outline said “up to 1 year.” However, in the studies that saw atrophy, it did not resolve within 2 years, and according to this NIH website, atrophy that is visible to the naked eye is often permanent.
- Unfortunately, hypertrophic and keloid scars are known to recur (come back) after treatment. Keloid scars are particularly likely to recur. Most studies on intralesional cytotoxic drugs only followed the patients for up to one year after treatment, and in that time, the scars did not recur. However, it is possible that hypertrophic and keloid scars might recur at some later point after intralesional treatment with cytotoxic drugs.
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