Lee Jae Hyun, Lim Soo Yeon, Lee Jang Hyun, Ahn Hee Chang
Department of Plastic and Reconstructive Surgery, Hanyang University College of Medicine, Seoul, Korea.
Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Arch Craniofac Surg. 2017 Sep;18(3):166-171. doi: 10.7181/acfs.2017.18.3.166. Epub 2017 Sep 26.
Localized 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.
We 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.
En 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.
We 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.
局限性硬皮病的特征是由于胶原蛋白过度沉积导致皮肤增厚。它不是一种致命疾病，但皮肤外观改变、关节挛缩，以及罕见的面部和四肢严重畸形会对生活质量产生不利影响。我们介绍了我们外科实践中6例面部局限性硬皮病病例。
我们回顾了2003年4月至2015年2月期间最初接受药物治疗然后接受后续手术的6例局限性硬皮病病例。6例患者有面部病变。这些病例表现为前额线性真皮硬化、脸颊椭圆形皮下和真皮凹陷。
剑伤样硬皮病（4例）和面部椭圆形病变（2例）均成功治疗。手术方法包括带或不带Z成形术的切除术（3例）、脂肪移植（1例）、真皮脂肪移植（1例）和游离脂肪筋膜瓣（1例）。受影响部位的畸形通过手术矫正，未复发。
我们回顾性分析了6例通过手术成功治疗的局限性硬皮病病例。并且我们提出了一种为个别局限性硬皮病病例选择最佳手术方法的算法。尽管我们的病例数量有限且需要长期随访，但我们建议手术治疗应被视为治疗硬皮病患者的一种选择。
