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

Owczarczyk‐Saczonek, Agnieszka; Kasprowicz-Furmańczyk, Marta; Kruszewska, Anna; Krajewska–Włodarczyk, Magdalena; Bechtold, Agata; Klimek, Paulina; Placek, Waldemar

doi:10.1007/s13555-020-00438-z

Cited by 11 publications

(11 citation statements)

References 39 publications

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“…The effects were confirmed by the patient and a clinical assessment, which included a reduction in the LoSDI score from 5 to 1. From our point of view, the combination of a hyaluronic acid fillers and FAL therapy allowed us to achieve better results than using one method only [33].…”

Section: Discussionmentioning

confidence: 92%

“…The use of laser treatments for autoimmune diseases, e.g., morphea, may be questionable and cause a fear of the recurrence of the disease [33]. Mechanical injuries are a known factor that can provoke the development of the disease [2].…”

Section: Discussionmentioning

confidence: 99%

“…We have proven that hyaluronic acid injections can be an effective and safe therapeutic option for patients suffering from LoSc, according to the example of three women with lesions on the facial area. One of the patients also had fractional ablative CO 2 laser (FAL) therapy to improve their skin hyperpigmentation [33].…”

Section: Introductionmentioning

confidence: 99%

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Fractional Ablative Carbon Dioxide Lasers for the Treatment of Morphea: A Case Series and Literature Review

Klimek

Placek

Owczarczyk‐Saczonek

2022

IJERPH

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Morphea is an inflammatory, immune-mediated disease of unknown aetiology. It is characterised by excessive collagen deposition, which leads to the hardening of the dermis and subcutaneous tissues. The disease is associated with cosmetic and functional impairment, which can affect the patients’ quality of life. Fractional ablative lasers (FALs) are currently used for the treatment of many skin diseases that are connected to tissue fibrosis due to the low risk of side effects and their great effectiveness. This study aimed to improve the aesthetic defects that are caused by morphea lesions and assess the efficacy and safety of FAL use in this indication. We also reviewed the literature on the subject. We present four women with biopsy-proven morphea, manifesting as hyperpigmented plaques and patches. One of the patients additionally had morphea-related knee joint contracture. Four fractional CO2 laser sessions, separated by one-month intervals, were performed and produced significant improvements in dyspigmentation and induration. An improved elasticity and a decrease in dermal thickness were also obtained, as proven by measurements using DermaLab Combo. No severe adverse effects occurred. Based on these cases presented by the authors, fractional CO2 lasers appear to be an effective, well-tolerated, and safe therapeutic option for patients suffering from morphea.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Fractional Ablative Carbon Dioxide Lasers for the Treatment of Morphea: A Case Series and Literature Review

Klimek

Placek

Owczarczyk‐Saczonek

2022

IJERPH

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“… Good result after 2 months; one patient maintained full correction even after 4 years. Pirrello et al 30 2019 10 Fibrosis, atrophy of the skin. Three filler injections of hyaluronic acid and platelet-rich plasma at an interval of 15 to 20 days.…”

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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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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“…It has been suspected that trauma may trigger morphea activation. Hence, several studies have advised that morphea should be quiescent prior to procedural treatments such as fat transfer [50][51][52].…”

Section: Discussionmentioning

confidence: 99%

Clinical and therapeutic course in head variants of linear morphea in adults: a retrospective review

et al. 2022

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Parry Romberg Syndrome (PRS) and en coup de sabre (ECDS) are head variants of linear morphea with functional and structural implications. This study describes the clinical course, autoimmune co-morbidities, complications, and treatment of adults with PRS/ECDS at a tertiary referral center. We retrospectively reviewed the records of all 34 adult patients with PRS/ECDS identified through billing code search and seen by dermatologists at our institution between 2015 and 2021. Eight patients (23.5%) had ECDS, 8 (23.5%) had PRS, and 18 (52.9%) had overlap. Twenty-six patients (76.5%) reported ocular, oral, and/or neurologic symptoms, and 8 (23.5%) had concomitant autoimmune/inflammatory conditions. Sixteen patients (47.1%) had a skin biopsy, and 25 (73.5%) had imaging. Forty-six MRIs were obtained, of which 6 (13.0%) reported intracranial findings and 25 (54.3%) reported disease-related connective tissue damage. Twenty-four patients (70.6%) underwent systemic treatment during their disease course per available clinical records. Seventeen patients (70.8%) had improved or stable disease upon treatment completion, with an average duration of 22.2 months. Ten patients (41.7%) reported recurrence of disease following the treatment course. To address changes to facial contour, 6 patients (17.6%) opted for procedural treatments. One patient (16.7%) experienced morphea reactivation following a filler injection performed off-immunosuppression. Compared to findings in children, our study suggests adults with PRS/ECDS are more likely to have oral and ocular complications but experience less severe neurologic symptoms. While systemic treatments appear beneficial in most adult patients with PRS/ECDS, disease may recur following discontinuation.

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

Cited by 11 publications

References 39 publications

Fractional Ablative Carbon Dioxide Lasers for the Treatment of Morphea: A Case Series and Literature Review

Fractional Ablative Carbon Dioxide Lasers for the Treatment of Morphea: A Case Series and Literature Review

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

Clinical and therapeutic course in head variants of linear morphea in adults: a retrospective review

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