Cranifacial Linear Scleroderma
Q: Dr. Eppley, I was diagnosed Linear Scleroderma at the age of 7 years old. Due to this disease it has created a bald spot that I am able to cover with my hair on the top on my head. This bald spot is about two inches wide and five inches long. I also have a dent on the left side of my forehead. This is something that I have always wanted taken care of and just to look and feel normal. I am able to come to a face to face consultation or I can do a virtual one as well.
A: Thank you for sending your pictures. You have a classic case of linear scleroderma that involves the first division of the trigeminal nerve. Thus its effects go from the eyebrow straight up in the scalp along the pathway of the nerve involving atrophy of bone and soft tissue.. I would treat your case with a two-stage approach that includes the following:
1st Stage = Placement of two scalp tissue expanders on each side of the wide scalp scar with fat injection grafting to the foreheads/brow.
2nd Stage (6 weeks later) – Removal of tissue expanders with excision of scalp scar and advancement of hair-bearing scalp flaps to cover it and placement of custom forehead-brow bone implant
Dr. Barry Eppley