Hyaluronidase Injections for Oral Microstomia in Systemic Sclerosis and Mixed Connective Tissue Disease

Min, Michelle S.; Goldman, Nathaniel; Mazori, Daniel R.; Guo, Lisa N.; Vleugels, Ruth Ann; LaChance, Avery H.

doi:10.1001/jamadermatol.2023.3893

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…Reports suggest that hyaluronidase contributes to the prevention and treatment of microstomia in systemic sclerosis or mixed connective tissue disease by hydrolyzing glucosaminidic and glycosidic bonds in hyaluronic acid and other connective tissue mucopolysaccharides [ 50 , 51 ]. Furthermore, improvements in microstomia have been observed in scleroderma patients treated with onabotulinumtoxin A, suggesting that multiple treatment approaches are available [ 52 ].…”

Section: Treatment Of Microstomiamentioning

confidence: 99%

Prevention and treatment of microstomia

Ki,

Park

2024

Arch Craniofac Surg

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The mouth, located in the lower third of the face, is a uniquely visible structure. It serves as a vital organ both aesthetically and functionally, playing a key role in speech, expression, and fundamental oral functions. Consequently, any alterations or defects in its shape, due to various causes, can lead to aesthetic and functional deficiencies. These issues may also result in challenges with social interactions and a decrease in confidence. In cases of microstomia, various surgical approaches are proposed based on the location, extent, shape, and cause of the defect, leading to numerous case reports. Plastic surgeons are proficient in oral reconstruction; however, cases of microstomia are relatively rare, which reduces their familiarity and interest in these cases. Additionally, preferences for oral size and shape vary according to factors such as geographical region and ethnicity, further complicating the functional definition of microstomia. Therefore, both subjective patient and physician judgments play crucial roles in the diagnosis and treatment of microstomia, as these may vary depending on individual and societal aspects. This review aims to classify the various causes and definitions of microstomia, as well as its non-surgical and surgical treatment options, with the goal of the treatment of this condition.

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Section: Treatment Of Microstomiamentioning

confidence: 99%

Prevention and treatment of microstomia

Ki,

Park

2024

Arch Craniofac Surg

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Perioral hyaluronidase injection for the treatment of microstomia in systemic sclerosis patients: A retrospective cohort study

Elgash,

Kim,

Swallow

et al. 2025

Journal of the American Academy of Dermatology

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Therapeutic Promise of Hyaluronidase in Systemic Sclerosis: A Systematic Review

Pulumati,

Lin,

Elman

2024

Dermatology Practical &Amp; Conceptual

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Introduction: Systemic sclerosis, also known as scleroderma, is a chronic disease marked by autoimmune-mediated damage to connective tissues leading to vascular damage, tissue injury, and fibrosis. Effective treatment for this condition has remained difficult; however, a promising therapeutic option for patients with systemic sclerosis has emerged as hyaluronidase. Objectives: We conducted a systemic review of the available literature to describe the therapeutic usage of hyaluronidase in systemic sclerosis. Methods: We conducted a comprehensive review on PubMed and Embase, using the terms: “hyaluronidase" AND "scleroderma," as well as “hyaluronidase” AND “systemic sclerosis.” Our criteria for inclusion were English-written articles published between 2013 and 2023. Only studies conducted on human subjects or in vitro on human cell lines were included. We excluded articles that did not discuss therapeutic use as well as articles that focused on medical conditions other than systemic sclerosis. Results: Ten articles were included in our review. Overall, intradermal hyaluronidase showed improvement in systemic sclerosis-associated microstomia via increased oral aperture with minimal side effects. Treatment protocol and outcome measured differed per case, however, multiple rounds of injections were necessary in all treatment courses. In some studies, a plateauing effect for hyaluronidase was seen after 3-5 months of injections. Conclusion: Case studies and case series have demonstrated hyaluronidase’s effectiveness in treating systemic sclerosis-associated microstomia, however, more research using larger sample sizes, standardized protocols, and specific outcomes such be conducted.

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Hyaluronidase Injections for Oral Microstomia in Systemic Sclerosis and Mixed Connective Tissue Disease

Abstract: This case series evaluates hyaluronidase for oral microstomia in a cohort of patients with autoimmune sclerosing disease.

Cited by 3 publications

References 8 publications

Prevention and treatment of microstomia

Prevention and treatment of microstomia

Perioral hyaluronidase injection for the treatment of microstomia in systemic sclerosis patients: A retrospective cohort study

Therapeutic Promise of Hyaluronidase in Systemic Sclerosis: A Systematic Review

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