Laparoscopic Sleeve Gastrectomy for Linear Scleroderma

Abstract

Linear scleroderma is a rare type of autoimmune connective-tissue disorder and is one of five known types of localized, nonsystemic scleroderma. This type of localized scleroderma affects the skin and subcutaneous tissues and induces extensive fibrosis and atrophy of the affected limbs. The disease is, characteristically, a unilateral phenomenon and usually affects the lower extremities. Due to its underlying pathophysiology, linear scleroderma is rarely associated with morbid obesity. This article documents the case of a 45-year-old female with a 35-year history of unilateral linear scleroderma, who subsequently developed morbid obesity of her contralateral side. Due to her linear scleroderma, she was unable to exercise effectively and developed hemiobesity associated with arthritis, lower back pain, and hypercholesterolemia. Based on her hemiobesity and associated comorbidities, she underwent a laparoscopic sleeve gastrectomy. Postoperatively, she has lost 20 kg or 75% of her excess weight, with a resolution of joint and back pain and hypercholesterolemia at 12-month follow-up. This article describes a unique application for a sleeve gastrectomy in the setting of linear scleroderma and hemiobesity.