Intra-articular corticosteroid injection may be associated with several adverse effects.1 Identification of aetiology of hypopigmentation in a child with juvenile idiopathic arthritis is important to guide appropriate therapy. A 10-year-old girl, with polyarticular juvenile idiopathic arthritis, presented with hypopigmentation over right wrist joint of 1-week duration. She had received oral naproxen for 6 weeks followed by weekly subcutaneous methotrexate (15 mg/m2). Triamcinolone acetonide (40 mg) was injected in her right wrist joint for persistent arthritis. Four weeks later, hypopigmentation was noted (figure 1). Systemic examination was unremarkable. Her blood counts, renal and liver function tests were normal. Hypopigmentation in our patient was attributed to intra-articular corticosteroid injection given the temporal association.
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