Idiopathic facial lipoatrophy in a healthy middle-aged woman!!
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Hello, a 40-year old woman presented with asymptomatic idiopathic facial lipoatrophy. The patient was otherwise healthy, taking no medications with no trauma or surgery in the region affected. Investigations, including a full autoimmune workup, were unremarkable. The facial lipoatrophy was considerably disfiguring and was assessed as a Grade 4 on the facial lipoatrophy scale. The patient was treated over the course of 2 years with two autologous fat transfers. How to treat this?
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@abhilan Lipoatrophy is defined as disappearance of the subcutaneous fat, without exudative reactions or appreciable fibrosis and just as lipodystophy, it is divided into generalized, partial and localized forms. Facial lipoatrophy describes the flattening or indentation of normally convex contours of the face and the most commonly affected areas are the cheeks, temples and the preauricular, orbital or perioral region. It is associated with inheritable diseases, acquired diseases and the natural aging process. Congenital causes often involve a general absence of fat, with associated metabolic findings such as insulin resistance and acanthosis nigricans before adolescence. The etiology of facial lipoatrophy is most commonly autoimmune in nature, but traumatic causes have also been identified. Facial lipoatrophy has been described as a feature of other conditions. The most common conditions associated with facial lipoatrophy are antiretroviral therapy for HIV infection and connective tissue disorders that are associated with panniculitis such as lupus lupus erythematosus profundus and localized scleroderma also known as morphea. Iatrogenic lipoatrophy is typically caused by medication injections. Further details on these other forms of lipodystrophy can be found elsewhere. Idiopathic Facial lipoatrophy is a rare condition that results in aesthetic disfiguration. The stigmata and psychological effect this can have on patients has significant potential implications on a patients’ quality of life
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