Localized scleroderma (LS) is an inflammatory sclerosing disease of unknown etiology characterized by progressive damage to connective tissue followed by the formation of sclerosis and/or atrophy of the skin and underlying tissues. The prevalence of LS is 27 cases per 1 million population per year, of which 3.4 cases occur in children. The use of autologous adipose tissue is a highly effective treatment method for patients with localized scleroderma, as confirmed by long-term results exceeding 1 year.

Autologous adipose tissue is considered an ideal filler due to its biocompatibility without the risk of allergic reactions, which is important for patients with autoimmune diseases

The purpose of this study. To substantiate and develop a methodology for auto transplantation of adipose tissue in the context of the use of systemic immunosuppressive therapy in the treatment and rehabilitation of children with localized scleroderma.

Materials and Methods. During the period from 2021 to 2025, lipofilling was performed on more than 80 patients diagnosed with localized scleroderma, with over 150 procedures conducted on children aged 6 to 18 years. From 1 to 3 stages of lipofilling were performed depending on the localization and size of the lesion.

Results and Discussion. As follows from the data and the series of clinical cases we have described, conservative therapy with systemic medications does not address the aesthetic problem in localized scleroderma, which causes aesthetic dissatisfaction in the majority of patients.

Fibrous and destructive changes in adipose tissue and skin depigmentation lead to subsequent phenotypic changes and facial atrophy. Allogeneic adipose tissue is an ideal material because it is completely autologous, which is very important for patients with autoimmune processes.

Thus, surgical treatment of children using autologous fat tissue allows to alleviate severe facial defects, improve the quality of life of children with LS, and increase their level of social adaptation. 

This is attributed to several factors: first, the lipoaspirate corrects the lost volume; second, the autograft has a positive impact on the thickness of the dermis and subcutaneous fat in the sclerotic area, leading to reduced skin density and tightness; and third, autologous fat tissue contains stem cells that possess a potent anti-inflammatory effect and reduce fibrosis by inhibiting the synthesis of extracellular matrix proteins and promoting collagen activity within the tissues.