Schneider Carolina, Parra Hernandez Luis A, Cure Eugenia, Salas Ingrid, Parra Andrea M
Plastic Surgery, Dra Carolina Schneider Plastic Surgery, Buenos Aires, ARG.
Aesthetic Medicine, Sociedad Internacional De Rejuvenecimiento Facial No Quirúrgico (SIRF), Barranquilla, COL.
Cureus. 2024 Sep 19;16(9):e69741. doi: 10.7759/cureus.69741. eCollection 2024 Sep.
Morphea, or localized scleroderma, is a chronic inflammatory condition that unequivocally affects the dermis and subcutaneous connective tissue. It undeniably causes significant disfigurement in approximately half of patients, profoundly impacting their self-esteem. The available treatment options include corticosteroids (taken orally or administered subcutaneously), phototherapy, CO fractional laser treatment, and biologically mediated medications. It is crucial to note that using fillers as adjuvant therapy for inflammatory diseases indisputably raises concerns due to the potential to trigger inflammation and lead to disease reactivation. In one case, a 24-year-old patient with morphea on her face underwent a combined approach involving plastic surgery, dermatology, and regenerative aesthetics treatment with lipo-filling initially by an expert plastic surgeon. Then, after reviewing the literature and consensus from the dermatologist, aesthetics physician, and alternative medicine expert, it was decided to use calcium hydroxylapatite-carboxymethylcellulose (Radiesse, Merz Pharmaceuticals GmbH, Frankfurt, Germany) in the affected area. After a year of follow-up, there was a significant improvement in the appearance of her face and skin, as confirmed by a 10-point improvement on an activity measuring scale. Additional research will solidify whether calcium hydroxylapatite (CaHA) is the optimal injectable for treating dermal autoimmune diseases. Our initial approach demonstrates significant promise for regenerative biostimulation. Through collaboration, we have effectively integrated plastic surgery techniques, fillers, dermatologists, and alternative medicine perspectives to treat inflammatory diseases, providing a comprehensive and robust exploration of morphea treatment.
硬斑病，即局限性硬皮病，是一种慢性炎症性疾病，明确会影响真皮和皮下结缔组织。不可否认，它会导致约半数患者出现明显的容貌毁损，对其自尊产生深远影响。现有的治疗选择包括皮质类固醇（口服或皮下注射）、光疗、二氧化碳分次激光治疗以及生物介导药物。需要注意的是，由于使用填充剂作为炎症性疾病的辅助治疗可能引发炎症并导致疾病复发，这无疑引发了人们的担忧。在一个案例中，一名面部患有硬斑病的24岁患者首先由一位专业整形外科医生采用了包括整形手术、皮肤科和脂肪填充再生美学治疗在内的联合方法。然后，在查阅皮肤科医生、美容医生和替代医学专家的文献并达成共识后，决定在患处使用羟基磷灰石 - 羧甲基纤维素（瑞蓝，德国法兰克福默克制药有限公司）。经过一年的随访，其面部外观和皮肤有了显著改善，这在一项活动测量量表上提高了10分得到了证实。更多研究将确定羟基磷灰石（CaHA）是否是治疗皮肤自身免疫性疾病的最佳可注射材料。我们最初的方法显示出再生生物刺激的巨大前景。通过合作，我们有效地整合了整形手术技术、填充剂、皮肤科医生和替代医学观点来治疗炎症性疾病，为硬斑病治疗提供了全面而有力的探索。
