Localized Lipoatrophy Following Glatiramer Acetate Injections: A Case Report of Treatment With Intralesional Normal Saline

Lipoatrophy at glatiramer acetate injection sites occurs in approximately 50% of multiple sclerosis (MS) patients and can be both disfiguring and permanent. To minimize the appearance of depressions at glatiramer acetate injection sites in a patient with MS, we employed a novel therapeutic modality in which normal saline was infiltrated into lipoatrophic plaques until blanching was noted. This treatment was administered weekly for a total of 4 treatments and successfully minimized the appearance of cutaneous depressions. Assessments by both the patient and physician indicated improvement in skin contour. Normal saline is effective in restoring skin contour depressions related to corticosteroid-induced lipoatrophy and also may be a successful treatment of lipoatrophy induced by glatiramer acetate injections. Further studies are needed to elucidate the exact mechanism by which normal saline restores surface contour related to lipoatrophy from glatiramer acetate injections.