A neoteric multidrug combination: novel approach to limited cutaneous systemic scleroderma involving the face

Abstract

Limited cutaneous scleroderma is a subtype of scleroderma limited to the skin of the face, hands, feet and forearms. We present a case of a 45-year-old woman affected by limited cutaneous systemic scleroderma involving the orofacial region and causing restricted mouth opening. The patient showed noteworthy improvement of the skin lesion by use of a combination of intralesional corticosteroid with hyaluronidase and various multiantioxidants, resulting in amelioration of her mouth opening problem. The patient gave her full informed written consent to this report being published.

Hyaluronidase injections for treatment of symptomatic pansclerotic morphea-induced microstomia

“…One case report describes it to be mildly efficacious in treating radiation-induced morphea 7 . However, there are several reports on the use of hyaluronidase injections in another sclerosing disorder, SSc, also known as scleroderma 2, 8, 9. Hyaluronidase injections have been used to successfully treat decreased oral aperture, or microstomia, in the context of perioral involvement of SSc 2, 8.…”

“…However, there are several reports on the use of hyaluronidase injections in another sclerosing disorder, SSc, also known as scleroderma 2, 8, 9. Hyaluronidase injections have been used to successfully treat decreased oral aperture, or microstomia, in the context of perioral involvement of SSc 2, 8. Notably, Melvin et al 2 described hyaluronidase injections for a 53-year-old woman with limited cutaneous SSc and disabling microstomia despite treatment with mycophenolate mofetil and systemic corticosteroids.…”

Hyaluronidase in Dermatology: Uses Beyond Hyaluronic Acid Fillers

“…40 The patient's sclerotic bands resolved almost completely and the patient could open her mouth more widely. 40 Scleredema Scleredema is a rare disorder of connective tissue, characterized by mucin deposition with skin induration. 41 It has been reported to occur after streptococcal infection 42 and in diabetic patients (scleredema diabeticorum).…”

“…[36][37][38][39] Abbas and colleagues 40 demonstrated the efficacy of hyaluronidase (four injections, 150IU) in improving sclerosis. 40 Their patient suffered from microstomia of the mouth resulting in tongue atrophy and decreased mouth-opening. 40 The patient's sclerotic bands resolved almost completely and the patient could open her mouth more widely.…”

“…40 Their patient suffered from microstomia of the mouth resulting in tongue atrophy and decreased mouth-opening. 40 The patient's sclerotic bands resolved almost completely and the patient could open her mouth more widely. 40 Scleredema Scleredema is a rare disorder of connective tissue, characterized by mucin deposition with skin induration.…”