Autologous fat grafting for treating lipoatrophy secondary to lupus erythematosus panniculitis

AbstractLupus erythematosus panniculitis (LEP) is an uncommon variant of LE and accounts for only 1–3% of cutaneous LE cases. LEP lesions often heal with cutaneous scarring and lipoatrophy resulting in disfigurement. Studies regarding the treatment of permanent lipoatrophy and disfigurement caused by LEP are lacking in the literature. Here, we report our experience with a rare case of lipoatrophy caused by LEP that was treated using autologous fat grafting. A 41-year-old woman presented with indurated, flesh-colored, depressed plaques on both buttocks. After a series of investigations, LEP was diagnosed by a rheumatologist. Magnetic resonance imaging (MRI) showed a markedly decreased volume of the subcutaneous fatty layer and thickening over the covering cutis. After the inflammatory disease was controlled, we attempted to restore her body contour with autologous fat grafting. We arranged an MRI study after a follow-up period of 12 months. The volume of subcutaneous fat was calculated by integrating cross-sectional area data from consecutive images. The patient was satisfied with her body contour following the injection of 350 mL of fat into the right buttock and 50 mL into the left buttock in a two-stage procedure. No complications were observed following the procedure. Follow-up laboratory results were negative for anti-double-stranded DNA antibody and showed normal complement levels. After a follow-up period of 12 months, no nodules or disease reactivation was noted. The MRI showed a marked improvement in the volume of the subcutaneous fat of the buttock, and the survival ratio of transferred fat was calculated to be 65%. Lipoatrophy secondary to LEP is a rare disease that can cause distress to patients. Autologous fat grafting is a simple, fast, and effective method for alleviating depression deformities in patients with LEP. It has a potentially long-lasting effect in treating patients with permanent lipoatrophy and disfigurement caused by LEP but should be preferably performed only in patients with quiescent disease