{
  "abstract": "Introduction Systemic sclerosis (SSc) is a rare connective tissue disease characterized by fibrosis, microvasculopathy, and autoimmunity. Patients often develop impaired hand function, Raynaud’s phenomenon, digital ulcers, and joint contractures, leading to reduced quality of life. Facial involvement further contributes to oral dysfunction and cosmetic disfigurement. In refractory cases, autologous fat grafting has emerged as a minimally invasive and safe therapeutic option with regenerative potential. The aim of this study was to evaluate the effects of autologous fat transfer on skin stiffness, hand function, and visual appearance perception in patients with systemic sclerosis.Material and Methods Patients who met the ACR/EULAR 2013 criteria for systemic sclerosis underwent autologous fat transfer performed by an experienced plastic surgeon. Assessments included the Cochin Hand Function Scale for hand function, the Modified Rodnan Skin Score (mRSS) and shear-wave elastography for skin stiffness, the Social Appearance Anxiety Scale (SAAS) for psychosocial evaluation, and the Raynaud Condition Score (RCS), hand pain visual analog scale (VAS), Merz Aestetic Scales and Health Assessment Questionnaire (HAQ). All evaluations were performed at baseline, 3, 6, and 12 months.Results Autologous fat transfer was performed in 6 patients. Three patients completed the 3-month follow-up. The mean age was 44.6 years and mean disease duration 5.6 years. At the 3. month, improvements were observed in Cochin score (14 vs 5; p=0.37), mRSS (9 vs 6; p=0.18), hand pain VAS (6 vs 2; p=0.37), and Raynaud Condition Score (4 vs 0; p=0.25). Shear-wave elastography indicated a trend toward reduced skin stiffness (right finger 5.15 vs 3.69; p=0.25, left finger 6.2 vs 3.73; p=0.25, right hand 3.78 vs 3.30 p=0.25, left hand 3.4 vs 3.29; p=1.00). Although not significant, SAAS (60 vs 23; p=0.16) and HAQ scores (0.875 vs 0.125; p=0.27) also improved, reflecting better psychosocial well-being and daily functioning. Photonumeric evaluation through Merz Aesththic Scales by a blinded dermatologist, revealed improvement of perioral wrinkles (2 vs 1) along with improvement in stiffness . No serious adverse events occurred; only transient pain, bruising and edema were observed at injection sites.Conclusions Autologous fat transfer appears a safe and feasible adjuvant modality in management of systemic sclerosis in selected cases. Early findings demonstrate benefits in hand function, skin stiffness, and psychosocial well-being. To strengthen the conclusions, further studies with larger patient cohorts and longer follow-up are planned.Abstract P.219 Table 1Comparison of elastography and clinical outcomes (baseline - 3rd month)Abstract P.219 Figure 1Images of a patient with systemic sclerosis before and after autologous fat grafting. (A) Baseline appearance. (B) Third month follow-up, showing decreased perioral wrinkles, improved skin homogeneity, and better aesthetic appearance",
  "authors": [
    {
      "affiliations": [
        "Marmara University School of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey"
      ],
      "name": "Aysegul Avcu"
    },
    {
      "affiliations": [
        "Marmara University School of Medicine, Department of Plastic Surgery, Istanbul, Turkey"
      ],
      "name": "Seyda Guray"
    },
    {
      "affiliations": [
        "Marmara University School of Medicine, Department of Radiology, Istanbul, Turkey"
      ],
      "name": "Halit Delibalta"
    },
    {
      "affiliations": [
        "Marmara University School of Medicine, Department of Radiology, Istanbul, Turkey"
      ],
      "name": "Onur Bugdayci"
    },
    {
      "affiliations": [
        "Marmara University School of Medicine, Department of Dermatology, Istanbul, Turkey"
      ],
      "name": "Tulin Ergun"
    },
    {
      "affiliations": [
        "Marmara University School of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey"
      ],
      "name": "Haner Direskeneli"
    },
    {
      "affiliations": [
        "Marmara University School of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey"
      ],
      "name": "Fatma Alibaz-Oner"
    }
  ],
  "title": "P.219 The effect of autologous fat transfer on skin stiffness, functional parameters and visual appearance perception in systemic sclerosis: preliminary results of a prospective study",
  "uid": "f921075a-16e7-54a1-a95a-28d4cab83fa7"
}