• Andrew Creadore, Jacqueline Watchmaker, Mayra B C Maymone, Leontios Pappas, Christina Lam, and Neelam A Vashi.
• Boston University School of Medicine, Boston, Massachusetts.
• J. Am. Acad. Dermatol. 2020 Aug 1; 83 (2): 315-341.

AbstractMorphea and systemic sclerosis are inflammatory, sclerosing disorders. Morphea primarily affects the dermis and subcutaneous fat, while systemic sclerosis typically involves the skin and internal organs. Functional impairment and cosmetic disfigurement are common in both diseases. Treatment options to mitigate disease progression remain limited. Both functional impairment and cosmetic deficits negatively impact quality of life and psychological well-being in this patient population. While the number of cosmetic procedures performed in the United States continues to rise each year, limited data exist regarding best practices for correcting aesthetic deficits caused by autoimmune conditions. There is scarce information to guide safety decisions regarding laser parameters, soft tissue augmentation, treatment intervals, and the concurrent use of immune-modifying or immune-suppressing medications. Given the fears of disease reactivation and exacerbation from postprocedural inflammation along with limited data, it is difficult for clinicians to provide evidence-based cosmetic treatment with realistic expectations with regard to short- and long-term outcomes. In the first article in this continuing medical education series, we attempt to address this practice gap.Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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