Treatment of Linear Scleroderma (<i>en Coup de Sabre</i>) With Dermal Fat Grafting

Barin, Ensar Zafer; Çinal, Hakan; Çakmak, Mehmet Akif; Tan, Önder

doi:10.1177/1203475415624912

Cited by 28 publications

(21 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Autologous fat tissue grafting, in addition to a filling effect, seems to have regenerative potentials presumably due to their adipose-derived stem cells (ASCs) content [ 5 ]. Currently, lipotransfer has been used for reversing fibrosis in various conditions such as scars, radio dermatitis, and localized forms of scleroderma such as “en coup de sabre” [ 6 , 7 ]. More recently, some reports have shown the efficacy of autologous fat grafting in patients with SSc to improve mouth opening and fibrosis reduction in the treated skin [ 5 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Autologous Fat Grafting in the Treatment of Facial Scleroderma

Gheisari

Ahmadzadeh

Nobari

et al. 2018

Dermatology Research and Practice

View full text Add to dashboard Cite

Systemic sclerosis (SSc) is a rare systemic autoimmune disease, characterized by progressive cutaneous and internal organ fibrosis. Orofacial manifestations of systemic sclerosis are extremely disabling and treatment options are limited. In this study, we aimed to assess the safety and efficacy of autologous fat grafting in the face of patients with systemic sclerosis. We enrolled 16 SSc patients suffering from facial sclerosis and limited mouth opening capacity. Autologous fat injection ranging from 15 to 40 ml was administered per patient, based on their face morphology. The patients were evaluated at baseline and 3 months after fat injection. Evaluations included mouth opening capacity, mouth handicap in systemic sclerosis (MHISS), Rodnan skin sclerosis score, skin biophysical properties using a sensitive biometrologic device with the assessment of cutaneous resonance running time (CRRT), volumizing and aesthetic effects based on pre- and posttreatment photographs, possible side effects, and global patient satisfaction. Clinical assessment showed autologous fat transfer significantly improved mouth opening capacity and the MHISS and Rodnan score of patients with facial scleroderma (p value <.001). The aesthetic and/or functional results of fat injection were satisfying to about 80% of the patients. The changes in CRRT values were not significant. Our findings support the possible therapeutic role of autologous fat grafting in improving facial scleroderma both in aesthetic and in functional aspects. This trial is registered with IRCT20180209038677N1.

show abstract

Section: Introductionmentioning

confidence: 99%

Autologous Fat Grafting in the Treatment of Facial Scleroderma

Gheisari

Ahmadzadeh

Nobari

et al. 2018

Dermatology Research and Practice

View full text Add to dashboard Cite

show abstract

“…Moreover, tissue expanders provide a sufficient skin flap for closure of the defect after resection of the lesion and obtain good results. However, tissue expander takes a long time to obtain effective results, and it may be a burden to patients as it requires additional surgeries [5].…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study, a technique that uses dermal fat graft for effective treatment of linear scleroderma was introduced [5]. The method used at our hospital is similar to that method, but in the present case, Medpor was used to improve bone contour since the depression in the frontal bone was noticeable.…”

Section: Discussionmentioning

confidence: 99%

A surgical approach to linear scleroderma using Medpor and dermal fat graft

Kim

Sun

Chung

2019

Arch Craniofac Surg

View full text Add to dashboard Cite

Linear scleroderma en coup de sabre (LScs) is a variant of localized scleroderma. This disease typically occurs in patients in their 20s or younger individuals and predominantly occurs in the forehead area. A 26-year-old man with linear scleroderma was surgically treated at our center with Medpor (porous polyethylene) and dermal fat graft for the forehead lesion. After 26 months of postoperative follow-up, the depressed lesion that appeared scarred as well as the margins improved significantly. The surgical treatment of LScs using Medpor and dermal fat graft is an effective treatment modality that can increase patient satisfaction.

show abstract

“…Current dermatological medical treatments for localized scleroderma (e.g., immune suppressants) are usually conservative and often do not yield thoroughly satisfying outcomes for patients. Furthermore, most existing research about surgical management options (e.g., filler [ 7 8 ], artificial dermis [ 9 ], artificial bone [ 10 ], hair transplantation [ 11 12 ], or fat or dermofat graft [ 13 14 15 16 ]) are case reports and, thus, lack a systematic analysis. None of our patients experienced significant clinical improvement with medication and were subsequently referred from the dermatology department.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the limitations of this conservative treatment and patients' expectations for a better quality of life, including aesthetic outcomes, more patients are increasingly preferring surgery over conservative treatment. However, most research into surgical management (e.g., filler [ 7 8 ], artificial dermis [ 9 ], artificial bone [ 10 ], hair transplantation [ 11 12 ], and fat or dermofat graft [ 13 14 15 16 ]) has been case reports, which lack a systemized study design compared with control-design research into medical treatments.…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Localized Scleroderma

Lee

Lim

Lee

et al. 2017

Arch Craniofac Surg

View full text Add to dashboard Cite

BackgroundLocalized scleroderma is characterized by a thickening of the skin from excessive collagen deposits. It is not a fatal disease, but quality of life can be adversely affected due to changes in skin appearance, joint contractures, and, rarely, serious deformities of the face and extremities. We present six cases of localized scleroderma in face from our surgical practice.MethodsWe reviewed six localized scleroderma cases that were initially treated with medication and then received follow-up surgery between April 2003 and February 2015. Six patients had facial lesions. These cases presented with linear dermal sclerosis on the forehead, oval subcutaneous and dermal depression in the cheek.ResultsEn coup de sabre (n=4), and oval-shaped lesion of the face (n=2) were successfully treated. Surgical methods included resection with or without Z-plasty (n=3), fat graft (n=1), dermofat graft (n=1), and adipofascial free flap (n=1). Deformities of the affected parts were surgically corrected without reoccurrence.ConclusionWe retrospectively reviewed six cases of localized scleroderma that were successfully treated with surgery. And we propose an algorithm for selecting the best surgical approach for individual localized scleroderma cases. Although our cases were limited in number and long-term follow-up will be necessary, we suggest that surgical management should be considered as an option for treating scleroderma patients.

show abstract

Treatment of Linear Scleroderma (en Coup de Sabre) With Dermal Fat Grafting

Abstract: We believe that dermal fat grafting is a cost-effective option and provides a long-lasting aesthetic outcome in the management of linear scleroderma.

Cited by 28 publications

References 8 publications

Autologous Fat Grafting in the Treatment of Facial Scleroderma

Autologous Fat Grafting in the Treatment of Facial Scleroderma

A surgical approach to linear scleroderma using Medpor and dermal fat graft

Surgical Management of Localized Scleroderma

Contact Info

Product

Resources

About