Sander Louise, Foeldvari Ivan, Glaser Daniel, Klotsche Jens, Stier Rebecca, Roldán Juan Camilo
Asklepios Medical School, ACH, Hamburg, Germany.
Hamburg Centre for Pediatric and Adolescent Rheumatology, Schön Klinik Hamburg Eilbek, Hamburg, Germany.
J Scleroderma Relat Disord. 2024 Oct;9(3):233-241. doi: 10.1177/23971983241241099. Epub 2024 Apr 8.
The objective of this study was to evaluate the effect of autologous fat grafting in patients with juvenile localized scleroderma with facial involvement.
We retrospectively studied patients with juvenile localized scleroderma who were followed at the Hamburg Center for Pediatric and Adolescent Rheumatology at least 6 months post-operative follow-up and received at least one autologous fat transplantation for a facial lesion. Autologous fat grafting was conducted independent of disease-modifying treatment and/or disease activity. The effectiveness of the intervention was evaluated by assessing the immediate volume enhancement after injection of fat tissue compared with volume retained after 6 months. The volume enhancement was calculated from three-dimensional photo images analyzed in Mirror Medical Imaging Software, Canfield Scientific (New Jersey, USA).
Data of 22 juvenile patients were assessed from March 2006 to September 2021. In six patients, the photos could not be evaluated for the study. The median age of the remaining 16 patients at the beginning of the first fat graft was 8 years (range = 2.5-22 years). Patients underwent mean three interventions (range = 1-9). Evaluation of three-dimensional images showed that the volume retention at 6 months post autologous fat grafting is approximately 50%. The Modified Localized Scleroderma Skin Severity Index value did not correlate to volume changes at 6 months. In 4 of 16 patients, a decrease of the Localized Scleroderma Damage Index occurred. In all seven patients with cheek involvement, mean tragus-nose distance difference decreased (mean decrease 1.09 cm). We did not observe any significant clinical side effects.
In this first bigger pediatric case series, the mean facial lesion volume increased around 50% after a mean of three interventions at 25 months of follow-up. No flares of the underlying disease were noted. Autologous fat grafting is a promising method to improve the cosmetic appearance of those patients.
本研究的目的是评估自体脂肪移植对青少年局限性硬皮病面部受累患者的疗效。
我们回顾性研究了青少年局限性硬皮病患者，这些患者在汉堡儿童和青少年风湿病中心接受了至少6个月的术后随访，并因面部病变接受了至少一次自体脂肪移植。自体脂肪移植独立于改善病情的治疗和/或疾病活动进行。通过比较注射脂肪组织后立即出现的体积增加与6个月后保留的体积，评估干预措施的有效性。体积增加量通过美国新泽西州Canfield Scientific公司的Mirror Medical Imaging Software软件分析的三维照片图像计算得出。
对2006年3月至2021年9月期间22例青少年患者的数据进行了评估。6例患者的照片无法用于本研究评估。其余16例患者首次进行脂肪移植时的中位年龄为8岁（范围为2.5 - 22岁）。患者平均接受了3次干预（范围为1 - 9次）。三维图像评估显示，自体脂肪移植后6个月的体积保留率约为50%。改良局限性硬皮病皮肤严重程度指数值与6个月时的体积变化无关。16例患者中有4例局限性硬皮病损伤指数下降。在所有7例脸颊受累的患者中，平均耳屏 - 鼻距离差减小（平均减小1.09 cm）。我们未观察到任何显著的临床副作用。
在这个首个较大规模的儿科病例系列中，经过平均25个月随访、平均3次干预后，面部病变平均体积增加了约50%。未观察到基础疾病的发作。自体脂肪移植是改善这些患者外观的一种有前景的方法。
