Title: Cosmetic Treatments in Head Variant Linear Morphea: A Retrospective Cohort Study Authors: Winnie Fan, BS,1 Bianca Obiakor, BS,1 Jason Pomerantz, MD,2 William Hoffman, MD,2 Matthew French, BS,3 and Anna Haemel, MD3

1. University of California, San Francisco School of Medicine, San Francisco, CA
2. Department of Plastics Surgery, University of California, San Francisco, San Francisco, CA
3. Department of Dermatology, University of California, San Francisco, San Francisco, CA

Introduction:

Head variant linear morphea, encompassing Parry Romberg Syndrome (PRS) and en coup de sabre (ECDS), is a sclerosing autoimmune disorder that can affect patients’ quality of life due to facial scarring and volume loss. Despite the potential of dermal injectables and fat transfers for cosmetic enhancement, data on their long-term efficacy, optimal timing, and safety remain limited in this patient population1,2.

Aims:

This study aimed to assess the efficacy, optimal treatment parameters, and outcomes of autologous fat transfers and injectable treatments in patients with head variant linear morphea.

Project Design/Methods:

This is an IRB-approved retrospective chart review of adult patients with head variant linear morphea seen at the UCSF Department of Dermatology and/or Plastic Surgery from 01/01/2015 to 06/13/2023. Patients who underwent cosmetic treatment (injectables/filler treatment of any type) to correct disease defects were included. Data on demographics, disease characteristics, treatment parameters, and patient/surgeon satisfaction were collected. Descriptive statistics were used to summarize the demographics and disease characteristics. To determine the association between disease stability at the time of treatment, use of systemic treatments at the time of cosmetic procedures, and the occurrence of post-treatment reactivation, chi-square tests of independence were performed, using a significance level of 0.05.

Results:

Twenty-one patients underwent cosmetic treatments for head variant linear morphea. The mean age was 37.1 years old, with a female predominance (90.5%). Most patients (71.4%) opted for cosmetic treatments after the disease was considered inactive by their clinicians. Autologous fat transfer was the preferred treatment (90.5%). Most patients (65.0%) reported aesthetic improvement, and 68.4% noted better symmetry. Surgeon assessments aligned closely with patient satisfaction, with 73.3% observing improved facial symmetry. Follow-up ranged from 4.3 to 185.15 months (mean 66.6 months). Three patients (14.3%) experienced disease reactivation post-treatment. There was a significant association between disease stability at the time of treatment and the absence of post-treatment reactivation (χ²(2) = 8.75, p

= 0.013). Similarly, a significant association was found between the use of systemic treatments during cosmetic procedures and the absence of disease reactivation (χ²(2) = 6.59, p = 0.037).

 

Discussion: