Novel use of poly-L-lactic acid filler for the treatment of facial cutaneous atrophy in patients with connective tissue disease

Background: Patients with connective tissue disease (CTD) often suffer from facial cutaneous defects and resultant facial asymmetry. Unfortunately, these issues have been known to be difficult-to-treat, and concern exists regarding the use of cosmetic procedures in this patient population due to the theoretical risk of disease flare-up or reactivation. Injectable poly-L-lactic acid (PLLA) is one type of filler that has been used to treat skin atrophy in patients with morphea and lupus erythematous panniculitis. However, overall, there is a dearth in literature regarding the safety and efficacy of PLLA filler in patients with CTDs. Aims: This case series intends to evaluate the safety and efficacy of PLLA filler in treating facial atrophy in patients with CTDs. Patients/Methods: Three patients underwent various treatment courses involving the use of PLLA filler to treat facial atrophy. Results: Two patients demonstrated significant improvement in facial atrophy following their treatment course. No patient experienced reactivation or exacerbation of their CTD following PLLA injection. Conclusion: PLLA filler appears to have good viability as a safe and potentially effective treatment for facial atrophy in patients with CTDs.