Multiple vs. single fat grafting benefits patients with morphea

Key takeaways:

• Patients treated with sequential vs. single grafting saw higher improvement in skin damage.
• On the other hand, both groups saw similar decreases in disease severity.

Sequential fat grafting with fresh fat and cryopreserved stromal vascular fraction gel was safe and beneficial for patients with morphea, according to a study.

“Morphea, or localized scleroderma, refers to a group of rare autoimmune connective tissue diseases with an incidence of 0.4 to 2.7 per 100,000 people,” Juzi Liu, MD, of the department of plastic and reconstructive surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China, and colleagues wrote. “Current treatment regimens mainly include topical immunomodulators, topical steroids and phototherapy.”

Sequential fat grafting using fresh fat and cryopreserved stromal vascular fraction (SVF) gel may also provide antisclerotic and regenerative effects to the skin of patients with morphea.

To evaluate this possibility, the authors conducted a single-center, nonrandomized controlled trial. In the trial, 44 patients (median age, 26 years; 36 women) with varying degrees of skin sclerosis and soft tissue defects from early- or late-onset morphea were split into two groups. The first group (n = 24) received sequential grafting of fresh fat and cryopreserved SVF gel at 1 month and 2 months after the operation. The second group (n = 20) received single autologous fat grafting.

Twelve months after treatment, two blinded dermatologists independently scored outcomes based on the modified Localized Scleroderma Skin Severity Index and Localized Scleroderma Skin Damage Index.

Results showed group one had more significant improvement in morphea skin damage compared with group two, with a skin damage score decrease of 4.3 vs. 2.1 (P < .001). On the other hand, both groups saw similar decreases in disease severity scores (1.6 vs. 0.9).

Skin biopsies revealed that group one experienced improved skin regeneration and reduced skin sclerosis, whereas group two did not show a significant change.

“The findings of this nonrandomized trial suggested that multiple grafting with fresh fat and cryopreserved SVF gel was safe and beneficial for patients with morphea,” the authors concluded. “Multiple injections of SVF gel were able to alleviate pathological skin sclerosis and help improve the volume-filling effect.”