Абстракт

Objectives: Considering the availability of a biocompatible and effective dermal filler and its sensible use in reconstructive and aesthetic medicine, this study aims to report a case of good response after a CaHA (calcium hydroxylapatite) filler treatment to improve skin quality in a patient with stable scleroderma. Introduction: Cosmetic treatments in patients with connective tissue disorders (CTD) is controversial, since there is a theoretical risk of ret-triggering the disease by immune activation. Despite this concern, recent studies have demonstrated that dermal fillers may be safe in patients with CTD. Among the different types of fillers, the choice for patients with CTD should be based on collagen stimulating properties, safety, and low potential to generate inflammation. Several studies have shown that average-sized CaHA microspheres stimulate neocollagenesis with minimal inflammatory response. Materials / method: Case report of 72-year-old woman diagnosed with scleroderma complaining of sagging and aged skin. Prior cosmetic procedure was performed with a PLLA filler. However, she presented a serious reaction following the application. Upon presentation, her disease was stable for 5 years, it was observed loss of facial contour and sagging. After informed consent was obtained, three separate sessions of CaHA diluted with 1,5 ml of lidocaine were performed, using fanning technique in the sub-dermal plane and 0,1ml aliquots were distributed to cover areas of middle and lower face. Results: The result observed was an improvement of flaccidity, in skin quality, and facial contour, including in the vector analysis, which was noticeable up to 1 year following the applications. The patient did not experience any adverse effects. Conclusion: This report shows that CaHA fillers are apparently possible alternatives for aesthetic treatments in patients with CTD. The biocompatibility and suitability of the CaHa filler for aesthetic correction are also applicable in reconstructive procedures for stable scleroderma, in a safe and minimally invasive way, with excellent aesthetic results. . More studies are needed to more accurately compare the properties of the different fillers available, regarding their mechanism of collagen induction, amount of collagen produced, durability and safety in the CTD population.