For acne cysts on the face, it is safer to use 1 to 2 mg/mL to make sure that atrophy does not occur. On the trunk consider using 2 to mg/mL of triamcinolone. Enough suspension should be injected to see and feel the cyst become distended, but no more than mL is needed for any one cyst. One injection site per acne cyst should be adequate. If the cyst is large and soft, do not inject more volume because that can lead to atrophy. If there is a lot of purulent material inside the cyst, a quick incision and drainage (with lidocaine and a No. 11 scalpel) before injecting the steroid may be helpful.
Chronic friction is a common etiological cause of lichen amyloidosis and treatment is usually directed at relieving the associated pruritus. Sedating antihistamines may help with relieving the itch, not because of their inherent antihistamine effects, but because of their inherent sedating qualities. Intralesional steroids may be useful alone or in combination with other modalities including topical steroids , topical tacrolimus and even treatment with UVB phototherapy may help alleviate the pruritus. Systemic acitretin can be effective, but only as long as the patient continues the therapy. Surgical excision and dermabrasion of isolated lesions can be performed.