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May 29, 2019

Hyaluronidase Treatment of Scleroderma-Induced Microstomia

Author Affiliations
  • 1School of Medicine, University of Alabama at Birmingham
  • 2Department of Dermatology, University of Alabama at Birmingham
  • 3Inverness Dermatology & Laser, Hoover, Alabama
JAMA Dermatol. 2019;155(7):857-859. doi:10.1001/jamadermatol.2019.0585

Systemic sclerosis (SSc) is a complex autoimmune connective tissue disease of unknown cause. The pathogenesis of SSc is characterized by microvascular fibroproliferative vasculopathy and immune dysregulation that promote excessive collagen and extracellular matrix deposition. Although many disease-modifying agents have been used to treat internal organ involvement, these medications often have modest efficacy on the cutaneous manifestations of SSc, including progressive facial dermal sclerosis.1 Microstomia, or limited mouth opening, is a common and debilitating cutaneous manifestation of SSc resulting in difficulty with mastication, phonation, and oral hygiene. Of note, a study of 300 patients with SSc found that facial involvement and microstomia were patients’ greatest concerns.2