Body Builder's Nightmare: Black Market Steroid Injection Gone Wrong: a Case Report

Abstract

In the pursuit of success in sports, some athletes are not deterred by health risks associated with the (mis)use of black market preparations of dubious origin as performance-enhancing agents. Several studies published in the recent years demonstrated that anabolic-androgenic steroids, but also stimulants and growth hormones, are misused by numerous recreational athletes from all over the world. Trenbolone is an anabolic steroid routinely used in the finishing phase of beef production to improve animal performance and feed efficiency. A 35-year-old male patient presented to our plastic surgery clinic after self-intramuscular administration of Trenbolone to the superior gluteal area bilaterally, which led to a full-thickness defect in a cone-like distribution. The wounds underwent surgical debridement and were treated locally with mafenide acetate irrigation and wound dressings. Closure was achieved by secondary intention healing. In this report, we discuss the first documented case of full-thickness skin and subcutaneous tissue necrosis after black market anabolic steroid injection. This illustrates a plastic complication and resolution of a widespread but seldom reported problem.

Fig. 1.

A 35-year-old healthy male referred by his physician due to painful skin necrosis approximately 5 × 4 cm and painful skin necrosis with purulent discharge on the right approximately 6.5 × 4 cm.

Fig. 2.

On ambulatory follow-up, the wound healed well with good granulation filling the wound and peripheral epithelialization shrinking the wound on the left to 3.5 × 3 cm and the wound to the right to 5 × 3 cm by 3 weeks after discharge.

Fig. 3.

At 6 weeks, wound dressings were changed to polyurethane. Almost complete epithelialization 1.5 months after discharge.

Fig. 4.

Complete epithelialization by 2 months after discharge.