Persistence of hyaluronic acid filler for subcutaneous atrophy in a case of circumscribed scleroderma

Arsiwala, Shehnaz

doi:10.4103/0974-2077.155099

Cited by 8 publications

(8 citation statements)

References 9 publications

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“…Thareja et al 24 Six months following the injections, the depressed lesion was adequately augmented with a favourable aesthetic outcome.…”

Section: Discussionmentioning

confidence: 98%

“…12 patients followed up for more than 3years showed persistent effect. Thareja et al 24 2013 1, En coup de sabre Linear vertical depression on left medial forehead and scalp with a hypo pigmented scar on the lower part associated with alopecia and atrophy of bony skull. Intradermal Hyaluronic acid filler Immediate improvement in volume.…”

Section: Discussionmentioning

confidence: 99%

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Hyaluronic Acid Filler Injection for Localized Scleroderma – Case Report and Review of Literature on Filler Injections for Localized Scleroderma

Sharad¹

2022

CCID

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Introduction Localized scleroderma, also known as Morphea, is a chronic inflammatory condition of connective tissue, the etiology of which is unknown. There is skin thickening with increased quantities of collagen in the indurative lesion. Skin hyperemia is seen in the early inflammatory stage. This is followed by fibrosis, sclerosis, and atrophy with hypopigmentation or hyperpigmentation. Therapeutic options include corticosteroids, oral or subcutaneous methotrexate, calcipotriol, imiquimod, tacrolimus, mycophenolate mofetil, medium-dose UVA1 phototherapy, and CO 2 fractional laser treatment. There is disfigurement in approximately 50% of patients. Surgical excision, autologous bone grafting, and autologous fat grafting have been performed with varying degrees of success in linear morphea. Hyaluronic acid, Calcium hydroxylapatite, Poly L lactic acid, and permanent fillers such as Silicone have been used to correct deformities that occur as a result of morphea. The aim of this case report was to establish hyaluronic acid fillers as an efficacious modality of treating stable localized morphea with facial disfigurement. Case Report A 35-year-old lady with stable localized scleroderma had an atrophic scar on the right side of her face extending from the labio-mental crease to the midline of the chin. The contour of the chin was lost leading to facial disfigurement. The atrophic scar was treated with 2 fillers with the same cross-linking polymer but two different G primes with excellent cosmetic outcome. A brief review of literature involving fillers for localized scleroderma is also discussed. Conclusion Hyaluronic acid filler can be used safely in cases of stable localized scleroderma with facial atrophies. It is an effective, minimally invasive treatment with minimal downtime. It is extremely important to inject fillers only in stable cases of localized morphea. This modality of treatment should be considered for a larger trial in patients with similar disfigurements.

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“…Thareja et al 24 Six months following the injections, the depressed lesion was adequately augmented with a favourable aesthetic outcome.…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Hyaluronic Acid Filler Injection for Localized Scleroderma – Case Report and Review of Literature on Filler Injections for Localized Scleroderma

Sharad¹

2022

CCID

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“…Therefore, as far as we know, this study attempted to demonstrate, for the first time, the effectiveness of local intradermal infiltrations of HA and PRP together in the treatment of facial skin fibrosis of SSc patients. Indeed, in other studies, hyaluronic acid has been used as a dermal filler in the treatment of a particular clinical variant of localized scleroderma, the so-called en coupe de saber [20, 21, 38, 39], but there are no evidences on the use of platelet-rich plasma when treating this disease.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, considering HA and PRP properties and their wide and valid use as filler in the treatment of skin lesions of several origin [22, 39–42], in this study, we used HA and PRP infiltrations to treat local facial scleroderma. Indeed, studies have demonstrated that hyaluronic acid fills the gaps and softens and moisturizes the skin for its capacity to bind water [20].…”

Section: Discussionmentioning

confidence: 99%

Hyaluronic acid and platelet-rich plasma, a new therapeutic alternative for scleroderma patients: a prospective open-label study

et al. 2019

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BackgroundSystemic sclerosis is a systemic connective tissue disease characterized by endothelium damage, fibrosis, and subsequent atrophy of the skin. Perioral fibrosis produces a characteristic microstomia together with microcheilia, both of which cause severe difficulties and affects patients’ daily life, such as eating and oral hygiene. Since there are no effective and specific therapies, we have aimed at evaluating the response to filler injections of hyaluronic acid together with platelet-rich plasma.MethodsTen female patients aged between 18 and 70 were included in this study. Each patient was treated with three filler injections of hyaluronic acid and platelet-rich plasma at an interval of 15 to 20 days. Follow-up check-ups were recorded 1, 3, and 24 months after the end of the treatment. During the therapy and the subsequent follow-up, we evaluated the mouth’s opening, freedom of movement of the lips, and skin elasticity.ResultsAfter the treatment, patients had achieved good results already after the first injection and the improvement was maintained in the following months, up to 2 years. In particular, 8 (80%) patients showed a greater mouth’s opening and increased upper lip’s thickness during 1-month follow-up and maintained these results after 2 years (maximum mouth’s opening T0 47.61; T3 49.23; T4 48.60 p < 0.0001. Upper lip’s thickness T0 4.20; T3 4.75; T4 4.45 p < 0.0001). Moreover, distance between upper and lower incisors (T0 27.05; T3 29.03; T4 28.14 p < 0.0001), inter-commissural distance (T0 49.12; T3 51.44; T4 50.31: p < 0.0001), and lower lip’s thickness (T0 3.80; T3 4.85, 5.10; T4 4.25; p < 0.0001) were increased in all of patients in 1-month follow-up, keeping these benefits after 24 months and having a significant increase of skin elasticity 1 month after the end of therapy.ConclusionsOur study demonstrates that filler injections of hyaluronic acid and platelet-rich plasma represent an efficient local therapeutic alternative for patients affected by scleroderma. The treatment has significantly improved patients’ quality of living.

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“…The literature provides reports on correction of facial defects in localized scleroderma (morphea, en coup de sabre, hemiatrophia faciei Parry-Romberg) using hyaluronic acid (HA) [ 10 – 12 ], polymethylmethacrylate [ 13 ], poly- l -lactic acid [ 14 ] and autologous fat [ 15 – 17 ] performed successfully and with no delayed type hypersensitivity.…”

Section: Introductionmentioning

confidence: 99%

The Correction of Facial Morphea Lesions by Hyaluronic Acid: A Case Series and Literature Review

Owczarczyk‐Saczonek¹,

Kasprowicz-Furmańczyk²,

Kruszewska³

et al. 2020

Dermatol Ther (Heidelb)

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Introduction: The aim of the study is to assess the long-term safety and efficacy of hyaluronic acid (HA) administration in correction of facial morphea lesions and to review the literature on the subject. Morphea is a chronic inflammatory disease of the connective tissue which may lead to serious deformations. The lesions located on the face particularly affect patients' quality of life and self-esteem; thus, there is a demand for safe and effective methods of treatment. Case Presentation: The paper presents three female patients aged 16, 17 and 70 with facial morphea lesions who had HA preparation Juvéderm Ò Voluma or Volux, Vycross Ò technology, Allergan, injected. One of the patients had additionally fractional ablative CO 2 laser (FAL) therapy. Discussion: The literature provides reports on successful use of HA, polymethylmethacrylate and poly-L-lactic acid for the correction of facial defects in localized scleroderma. HA is a natural component of the extracellular matrix and it therefore minimizes the probability of immunogenicity. The application technique also plays an important role. On the other hand, FAL therapy leads to the degradation of the abnormal collagen and the induction of normal collagen synthesis. Conclusions: HA injection and combination of HA application with FAL are minimally invasive, effective and safe therapeutic options for patients suffering from morphea.

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Persistence of hyaluronic acid filler for subcutaneous atrophy in a case of circumscribed scleroderma

Cited by 8 publications

References 9 publications

Hyaluronic Acid Filler Injection for Localized Scleroderma – Case Report and Review of Literature on Filler Injections for Localized Scleroderma

Hyaluronic Acid Filler Injection for Localized Scleroderma – Case Report and Review of Literature on Filler Injections for Localized Scleroderma

Hyaluronic acid and platelet-rich plasma, a new therapeutic alternative for scleroderma patients: a prospective open-label study

The Correction of Facial Morphea Lesions by Hyaluronic Acid: A Case Series and Literature Review

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