36º Congresso Brasileiro de Reumatologia

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Title

AUTOLOGOUS LIPOENXERTIA IN FACIAL LUPUS PANNICULITIS - CASE REPORT

Background

Lupus panniculitis is an uncommon presentation of chronic cutaneous lupus. However, it can generate large deformities, impairing the appearance of the face and consequent impact on the quality of life. Some procedures can be performed to repair the affected area, such as autologous fat transplantation, which is safe when performed in non-inflamed regions.

Case report

A 62-year-old female patient with a history of systemic lupus erythematosus (SLE) for 14 years, with previous cutaneous, joint and pulmonary involvement (usual interstitial pneumonia in computed tomography of the thorax); FAN 1/640 dense thin dotted cytoplasmic reagent. After the first year of onset of SLE, he had edematous, erythematous and nodular plaques on the face and proximal region of the upper limbs. The biopsy revealed necrotizing vasculitis of small vessels in the deep dermis and subcutaneous adipose tissue. Due to lupus panniculitis, she was treated with azathioprine and corticoid, with good response. During the follow-up, there was a significant atrophy of subcutaneous tissue in the face (bilateral infra-malar region) and proximal arms, with significant aesthetic impairment. In remission of SLE, it was then submitted to autologous lipoenxertia on the face, with adipose tissue from the abdominal region. Reassessed after 40 days of the surgical procedure, without complications, facial mime preserved, was satisfied with aesthetic result and reported improved self-esteem.

Conclusion

Lipoenxertia is a safe method, with minimal complications, and can be used in facial reconstruction. In the present case, the good response of the procedure reflected in the improvement of the quality of life of the patient.

Área

Systemic Lupus Erythematosus

Autores

Thiago Reis De Santana, Luiza Todt Cardoso De Faro , Giovana Dutra Saquy, Jose Caetano Macieira, Monica Valeria Siqueira Santana De Vechi, Blenda Hilíria De Sousa Dias, Lina Oliveira De Carvalho, Regina Adalva De Lucena Couto Ocea