Hi Dr McNaughton

Thank you for your question. Attached please find 2 case reports with detailed explanation on dosing, intervals and technique for intralesional use of triamcinolone acetonide (Kenalog, 40 mg/ml) for pyoderma. Brief summary below:

• Goldstein, 1985: reported successful outcomes after 1 injection: "A total of 100 mg was injected using a solution of 40 mg/ml (Kenalog, 40 mg injection) and injecting divided doses through a 30-gauge needle into eight sites surrounding the margin of the lesion".
• Jennings, 1983: reported successful outcomes of the larger ulcer after 2 injections: "The ulcer was then injected with triamcinolone acetonide suspension. Entering from the most peripheral border of the violaceous advancing edge and aiming toward the center of the ulcer, triamcinolone acetonide (10 mg/ml) in 0.3- to 0.4-ml quantities was injected with a 30-gauge, 1-inch needle around the entire ulcer. A total of 6 ml was injected." 16 days later, authors administered 1ml in total, in the same fashion.

Hope that helps!