深在性エリテマトーデスによる顔面陥凹変形に対し深下腹壁動脈真皮脂肪弁を施行した1症例

抄録

 There are many reported cases of free flap reconstruction for facial deformities however, our thorough search of the literature revealed only 2 such cases arising from lupus erythematosus profundus.
 In this paper, we report our experience from the reconstruction of a contracted, lupus scar due to long-term internal administration of prednisolone. A free DIEA dermal-fat flap was used with a good outcome to reconstruct an area of pitted atrophy on the left side of the face.
 A 65-year-old female was diagnosed with systemic lupus erythematosus(SLE)around the year 2000 and began treatment by internal administration of prednisolone ordered by a local dermatologist. Lupus erythematosus profundus developed concurrently in 2005 and led to a severe facial pitting deformity. The illness subsequently remitted, and the patient was referred to our department for reconstruction.
 A skin flap configuration was devised to minimize the absorption of fat at the atrophic focus, where circulation was regarded as poor, and to prevent hardening of the reconstructed cheek region, and a good outcome was obtained. Currently at 1 year postoperatively, fat volume is adequate on palpation, and flexibility is also reconstituted.