Arch Craniofac Surg.  2017 Sep;18(3):166-171. 10.7181/acfs.2017.18.3.166.

Surgical Management of Localized Scleroderma

• Lee JH
• Lim SY
• Lee JH
• Ahn HC

• KMID: 2390351
• DOI: http://doi.org/10.7181/acfs.2017.18.3.166

Abstract

BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSION
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.

Keyword

Localized scleroderma; Linear scleroderma; Morphea; Dermatosclerosis

MeSH Terms

Cheek
Collagen
Congenital Abnormalities
Contracture
Depression
Extremities
Follow-Up Studies
Forehead
Free Tissue Flaps
Humans
Joints
Quality of Life
Retrospective Studies
Scleroderma, Localized*
Sclerosis
Skin
Transplants
Collagen