Dermal Grafting for a Patient with Scleroderma: Case report

Abstract

Scleroderma is a connective tissue disorder which includes fibrosis of the skin. Facial skin contraction leads to loss of forehead, periorbital, and nasolabial wrinkling and at the same time causes radial furrows around the contracted oral opening (microstomia). The lips become retracted. We describe a 41 year old lady whose upper lip was treated by free dermal graft and injection of fat to improve her perioral aesthetic appearance. The skin was taken from the right submammary fold and the fat was obtained from the abdomen by liposuction. Excess fat was stored in a sterile container at -70 degrees C for future use. The patient made a satisfactory recovery and has asked for her lower lip to be treated in the same way.

Review of the Current Medical and Surgical Treatment Options for Microstomia in Patients With Scleroderma

“…The first case involved a 41-year-old woman who received AFG injections along the nasolabial fold, which led to an improved oral aperture and lip fullness 6 weeks postoperatively. 20 A more recent case involved injection of 19.8 mL of microfat taken from the inner part of the knees, which led to an improvement in oral aperture and Mouth Handicap in Systemic Sclerosis (MHISS) score. 21 A case series of 2 patients employed the use of AFG prepared with PRP.…”

Treatment of Atrophies Secondary to Trilinear Scleroderma En Coup de Sabre by Autologous Tissue Cocktail Injection

“…Several surgical techniques have been attempted to correct frontoparietal scleroderma. These are soft‐tissue expansion with autologous bone grafting, 3 autologous fat transplantation, 4 dermal grafting, 5 and en bloc autologous fat graft 6 . However, the treatment of frontoparietal scleroderma affecting a relatively wide area of the scalp and forehead has been unsatisfactory.…”

Deep Phenol Peeling and Fat Injection: Treatment Option for Perioral Wrinkles in a Scleroderma Patient

“…For this reason, surgical interventions are done with considerable caution. A successful fat injection for esthetic purposes was already reported for these patients 13,14 . Apfelberg and colleagues reported successful treatment of perioral rhytids in three scleroderma patients using CO 2 laser resurfacing 15 …”

“…A successful fat injection for esthetic purposes was already reported for these patients. 13,14 Apfelberg and colleagues reported successful treatment of perioral rhytids in three scleroderma patients using CO 2 laser resurfacing. 15 It is known that in phenol peeling, the depth of injury cannot be controlled precisely, in contrast to skin resurfacing performed using the CO 2 laser, 16 but some physicians dealing with peelings believe that very deep wrinkles may be treated better using preparations containing phenol.…”