Use of Botulinum Toxin and Hyaluronic Acid Filler to Treat Oral Involvement in Scleroderma

Abstract

ptosis, headache, nausea, vomiting, dizziness, tinnitus, and urinary urgency. At their initial ophthalmology evaluation, 6 patients had no light perception in the affected eye. Of these cases, 2 patients had care by ophthalmologists that included a vitrectomy in 1 case; neither had visual improvement by the final follow-up. The only case of vision recovery involved a patient whose visual acuity had declined to 20/200 after PRP injection. 5 This patient was evaluated and treated by an ophthalmologist within 3 hours of symptom onset. She had a full recovery of visual acuity at 3 months but with residual deficits on eye examination.Limitations of this study include a general lack of details on PRP injection technique in all cases. It is unknown whether soft tissue fillers were mixed with PRP in any of the cases. Furthermore, treatment and follow-up were limited in several cases.This systematic review shows that vision loss is a potential rare but devastating complication of PRP injections. Highly concentrated platelets may act as a procoagulant when injected intravascularly leading to occlusion and ischemia. Given this risk, physicians must use similar precautions when injecting PRP as when injecting soft tissue fillers. The glabella and forehead appear to be high-risk areas, but injection locations as distant as TMJ and nasolabial fold are not risk-free. Vision loss after PRP can be complete and irreversible. However, early evaluation and treatment may be helpful in cases of partial vision loss.

Treatment of Scleroderma-Related Microstomia Using Hyaluronic Acid: An Interventional Study

“…Yet, this therapy was not found to have an effect on facial tissue atrophy [38]. Cumsky et al [39] recently published their experience using a combination of hyaluronic acid filler and botulinum toxin. They achieved significant improvements in patients' ability to drink, eat and retain food by 1 month after treatment.…”

Hyaluronic acid‐based fillers in patients with autoimmune inflammatory diseases

“…In the first case, a 42‐year‐old woman with symptomatic systemic sclerosis and skin lesions on hands and mouth was treated with botulinum toxin and HA‐based fillers. One month after treatment, the patient showed significant improvement in the skin lesions, with no occurrence of adverse events or worsening of the disease 8 . In another case report, a 35‐year‐old woman with asymptomatic localized sclerosis and an atrophic scar on chin was treated with HA 1 mL.…”

“…One month after treatment, the patient showed significant improvement in the skin lesions, with no occurrence of adverse events or worsening of the disease. 8 In another case report, a 35-year-old woman with asymptomatic localized sclerosis and an atrophic scar on chin was treated with HA 1 mL. No adverse events were reported, and the procedure was well tolerated.…”

Selected aesthetic medicine treatment in patients with autoimmune diseases - a literature review

“…W pierwszym przypadku 42letnia kobieta z objawami twardziny układowej i zmianami skórnymi na dłoniach i ustach była leczona toksyną botulinową i wypełniaczami na bazie HA. Miesiąc po leczeniu pacjentka wykazała znaczną poprawę zmian skórnych, bez wystąpienia działań niepożądanych lub pogorszenia choroby [15]. W innym opisie przypadku 35-letnia kobieta z bezobjawowym stwardnieniem miejscowym i zanikową blizną na brodzie otrzymała iniekcję HA.…”