The cutaneous manifestations of lupus, especially chronic lupus erythematosus, are a source of significant morbidity and can adversely affect a patient's quality of life. While the active inflammatory component of the disease can be adequately treated, patients are often left with residual skin damage and an aesthetic defect. Dermatologists lack guidance regarding the use and safety of various reconstructive and cosmetic interventions for this patient population. In the article on estet-portal.com you will learn about the results of cosmetic interventions in patients with systemic lupus erythematosus.
- Systemic lupus erythematosus: background information on cosmetic procedures
- Use of laser technology for patients diagnosed with systemic lupus erythematosus
- Can injection procedures be used for a diagnosis of systemic lupus erythematosus?
- Conclusion
Systemic lupus erythematosus: background information on cosmetic procedures
Laser therapy is largely avoided in people with lupus due to possible UV and visible light photodamage. Similarly, given the autoimmune nature of the disease, some physicians avoid injection treatments and transplants for fear of reactivating the disease through antigen stimulation.
In the past, laser therapy has been controversial in patients with lupus erythematosus, given the photo-sensitive nature of the disease.
Read also: Principles of diagnosis and treatment of systemic lupus erythematosus.
The combination of photoprotection, medical management with topical immunomodulators and antimalarial drugs remains the first line of treatment for skin manifestations of
Despite the above facts, there have been quite a few recent trials and randomized clinical trials that have shown excellent results in the use of lasers for the treatment of erythema, & nbsp; associated with lupus erythematosus in the active period, as well as for the treatment of hyperpigmentation and scarring in the inactive period of the disease.
Discoid lesions of lupus erythematosus difficult to treat because these lesions include telangiectasias, hyperpigmentation, and scarring. The combination of IPL and Q-switch neodymium laser (Nd:YAG) is reported to be well tolerated for the treatment of patients with active discoid lesions. Considering the fact that the technology IPL targets more superficial telangiectasia, and Nd:YAG on dermal melanosomes - the combination of these two methods works great for aesthetic problems in patients with systemic lupus erythematosus.
Read also: Skin Therapy for Systemic Lupus Erythematosus. Nd:YAG is a non-ablative laser that induces the formation of dermal collagen while reducing the potential risk of epidermal wounds.
Erbium yttrium aluminum garnet laser, Er:YAG, is also widely used for treatment of discoid cicatricial lupus.
The ablative laser modality of these lasers sacrifices the efficiency of dermal collagen production in order to reduce tissue damage and healing time compared to CO2 ablative lasers.
In addition, argon lasers (non-ablative) have been used to treat erythematous, hyperkeratotic plaques and telangiectasias in active period of the disease, with subjective resolution of lesions and the absence of scars or pigmentary changes during & nbsp; 6 months. Previously, argon lasers were actively used for the treatment of & nbsp; vascular and pigmented lesions, but the advantage of selective thermolysis and thus the reduction of scarring and pigmentary changes seen in newer pulsed dye lasers (PDLs), led to a decrease in the use of argon (non-ablative) lasers.
IPL technologies have been successfully used in the treatment of chronic erythema and facial burning associated with a diagnosis of systemic lupus erythematosus.
In addition to IPL, several studies have shown that the use of PDL at low frequencies is well tolerated in the treatment of vascular & nbsp; component of skin lesions in patients with lupus, and also inhibits the migration of inflammatory cells.
Data on the reduction of inflammatory cells and their migration are confirmed histopathological
results of patient biopsy. Is it possible to resort to injection procedures for the diagnosis of systemic lupus erythematosus
Injection procedures for patients with lupus erythematosus, as well as for patients with other systemic inflammatory diseases, are not performed, due to the theoretical risk of exacerbation or reactivation of the disease caused by tissue stimulation.
Recently, more and more positive results are being achieved using injection techniques to correct atrophic lesions in lupus erythematosus.
Hyaluronic acid, poly-L lactic acid, polyacrylamide hydrogel showed subjective satisfactory results without adverse reactions or disease exacerbation in patients with lupus erythematosus. Documented side effects include edema, transient erythema, ecchymosis, hematoma, tenderness, inflammatory masses and granulomas.
Hyaluronidase enzyme in cosmetology. Side effects in the form of nodules mainly appeared when using fillers with low molecular weight hyaluronic acid, several sessions of injections of hyaluronidase and triamcinolone were required to dissolve these nodules. Patients observed the first signs of nodules after a year or more.
To prevent complications, all injection procedures should be performed during remission and in the absence of any medical treatment, such as immunosuppressive drugs.
Invasive surgical procedures in patients with lupus erythematosus are expected to lead to such & nbsp; complications, such as relapse of the disease, hypercoagulability and reduced regeneration, due to the use of immunosuppressants. Systemic manifestations from other organs and systems are also possible. In case of deciding on reconstructive surgery, the use of implants increases the risk of complications and increases the risk of complications, it is preferable to use
patient's autologous fat. Conclusion
There is a need for reconstructive interventions in the population with systemic lupus erythematosus, but due to potential complications, often specialists refuse to provide services to such patients. To prevent complications, the specialist should take a detailed history and warn the patient & nbsp; about the consequences.
Research is still ongoing to provide comprehensive information and guidelines for professionals working with patients diagnosed with systemic lupus erythematosus.
Source articles :JAAD.
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