Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China.
State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Aesthetic Plast Surg. 2023 Oct;47(5):2084-2092. doi: 10.1007/s00266-023-03543-4. Epub 2023 Aug 17.
Localized scleroderma (LS) is characterized by skin fibrosis, hyperpigmentation and soft tissue atrophy. Fat grafting has been widely used to correct LS deformity.
To investigate the effect of fat grafting on the skin pigmentation of LS lesions.
A prospective self-controlled study was conducted. Skin melanin and erythema indexes were measured by Mexameter® MX18 before and 3 months after surgery. Differences between lesions and contralateral normal sites were compared to evaluate changes induced by fat grafting. Localized Scleroderma Cutaneous Assessment Tool and PUMC Localized Scleroderma Facial Aesthetic Index were used for clinical evaluation.
Fourteen frontal linear LS patients participated in the study. Before surgery, the melanin index of the lesions was significantly higher than the contralateral sites (p = 0.023), while the erythema indexes were not significantly different (p = 0.426). Three months post-operation, the melanin index of the lesions significantly decreased (p = 0.008). There was no significant change in the erythema index of the lesions before and after fat grafting (p = 0.322). The LoSCAT and PUMC LSFAI scores demonstrated improved disease condition and facial esthetics after surgery.
Fat grafting could alleviate skin hyperpigmentation and skin damage of LS lesions while having little effect on skin erythema and disease activity.
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局限性硬皮病（LS）的特征为皮肤纤维化、色素沉着和软组织萎缩。脂肪移植已广泛用于矫正 LS 畸形。
研究脂肪移植对 LS 病变皮肤色素沉着的影响。
前瞻性自身对照研究。采用 Mexameter® MX18 分别于术前和术后 3 个月测量皮肤黑素和红斑指数。比较病变与对侧正常部位之间的差异，以评估脂肪移植的诱导作用。采用局限性硬皮病皮肤评估工具（LoSCAT）和中国医学科学院整形外科医院局限性硬皮病面部美学指数（PUMC LSFAI）进行临床评估。
14 例额部线状 LS 患者参与了本研究。术前，病变部位的黑素指数明显高于对侧（p=0.023），而红斑指数无明显差异（p=0.426）。术后 3 个月，病变部位黑素指数显著降低（p=0.008）。脂肪移植前后病变部位红斑指数无明显变化（p=0.322）。LoSCAT 和 PUMC LSFAI 评分显示术后疾病状况和面部美观度均有改善。
脂肪移植可减轻 LS 病变皮肤色素沉着和皮肤损伤，而对皮肤红斑和疾病活动度影响较小。
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