Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Autologous Fat Transfer in Lupus Panniculitis Facial Lipoatrophy

  • Kongkunnavat, Natthapong (Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Prathyajuta, Jirapat (Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Tonaree, Warangkana (Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University)
  • Published : 2022.07.15
Download PDF
⟨ Previous Next ⟩

Abstract

Lupus panniculitis (LP) often presents with tender nodules and intermittent ulcers that then heal with scarring and lipoatrophy. The current mainstay of treatment is medical treatment. Research regarding the treatment of lipoatrophy from LP with autologous fat grafting is limited. We would like to share our experience in this rare case, which was treated with autologous fat transfer. A 48-year-old female presented with erythematous plaque, tender nodules, and ulcers following by a depression of the lesion at the left temporal area. The patient also had indurated erythematous plaque at her left cheek. Both lesions were aggravated by sunlight exposure. After several investigations, she was diagnosed as LP with secondary lipoatrophy and tumid lupus erythematosus at her left temporal and left cheek, respectively. She received antimalarial drug and topical steroids. The patient underwent two sessions of autologous fat transfer. She was satisfied with the volume and contour improvement in the scar following the injection of 8 and 3.7 mL of fat. Furthermore, the patient reported the remission of tender nodules and ulcers since the first fat graft injection. In conclusion, the autologous fat transfer is a simple and effective treatment for lipoatrophy and scar secondary to LP with promising results.

Keywords

References

  1. Al-Refu K, Goodfield M. Scar classification in cutaneous lupus erythematosus: morphological description. Br J Dermatol 2009;161(05):1052-1058 https://doi.org/10.1111/j.1365-2133.2009.09313.x
  2. Vasquez R, Wang D, Tran QP, et al. A multicentre, cross-sectional study on quality of life in patients with cutaneous lupus erythematosus. Br J Dermatol 2013;168(01):145-153 https://doi.org/10.1111/j.1365-2133.2012.11106.x
  3. Fanouriakis A, Kostopoulou M, Alunno A, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis 2019;78(06):736-745 https://doi.org/10.1136/annrheumdis-2019-215089
  4. Creadore A, Watchmaker J, Maymone MBC, Pappas L, Vashi NA, Lam C. Cosmetic treatment in patients with autoimmune connective tissue diseases: best practices for patients with lupus erythematosus. J Am Acad Dermatol 2020;83(02):343-363 https://doi.org/10.1016/j.jaad.2020.03.123
  5. Eastham AB, Liang CA, Femia AN, Lee TC, Vleugels RA, Merola JF. Lupus erythematosus panniculitis-induced facial atrophy: effective treatment with poly-L-lactic acid and hyaluronic acid dermal fillers. J Am Acad Dermatol 2013;69(05):e260-e262 https://doi.org/10.1016/j.jaad.2013.06.037
  6. Gleeson CM, Lucas S, Langrish CJ, Barlow RJ. Acute fatal fat tissue embolism after autologous fat transfer in a patient with lupus profundus. Dermatol Surg 2011;37(01):111-115 https://doi.org/10.1111/j.1524-4725.2010.01829.x
  7. Valdatta L, Cherubino M, Tamborini F, Pellegatta I, Maggiulli F. A case of facial lipoatrophy secondary to lupus profundus managed with lipofilling technique. Case Rep Dermatol Med 2012;2012:720518 https://doi.org/10.1155/2012/720518
  8. Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 2006;118(3, Suppl):108S-120S https://doi.org/10.1097/01.prs.0000234610.81672.e7
  9. Agay D, Scherthan H, Forcheron F, et al. Multipotent mesenchymal stem cell grafting to treat cutaneous radiation syndrome: development of a new minipig model. Exp Hematol 2010;38(10):945-956 https://doi.org/10.1016/j.exphem.2010.06.008
  10. Charles-de-Sa L, Gontijo-de-Amorim NF, Maeda Takiya C, et al. Antiaging treatment of the facial skin by fat graft and adipose-derived stem cells. Plast Reconstr Surg 2015;135(04):999-1009 https://doi.org/10.1097/PRS.0000000000001123