For facial lipoatrophy
Head of the Department: Prof. Facial lipoatrophy refers to the loss of subcutaneous fat tissue presenting by flattening or indentation of convex contour of the face. Facial lipoatrophy is a feature of the normal ageing process. It may be also a manifestation of chronic diseases, most frequently it affects HIV-infected individuals treated with highly active antiretroviral therapy HAART and may constitute a complication of connective tissue diseases, like lupus erythematosus profundus or morphea. Early recognition and treatment of the active stage of connective tissue diseases is of essential significance in prevention of subsequent scarring and atrophy lesions.
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Acquired facial lipoatrophy: pathogenesis and therapeutic options
Restorative Treatment for HIV-Associated Lipoatrophy
HIV-related lipoatrophy fat loss under the skin is a clinical problem that affects many people living with HIV. Lipoatrophy can cause substantial loss of buttock tissue, veiny legs and arms, and facial wasting. Lipoatrophy can happen alone or in combination with lipohypertrophy fat accumulation in the visceral organ and dorsocervical back of the neck area. These body changes, with or without blood level alterations of cholesterol, triglycerides, lactic acid, glucose, and insulin, is called HIV-related lipodystrophy syndrome. Many of these body changes occur normally with aging, but being HIV positive seems to accelerate their development. Many observational cohorts and studies to determine the causes and potential treatments of lipodystrophy have been performed since , the first year when we realized that living longer with HIV may be accompanied with side effects like body changes.
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Face to Face With Lipoatrophy
Bio-Alcamid treatment for HIV-related lipoatrophy is associated with a high-rate of infectious complications, Canadian investigators report in the online edition of Clinical Infectious Diseases. The infections typically developed years after initial therapy with Bio-Alcamid and dental work and facial manipulation were risk factors. Facial lipoatrophy was recognised as a potential side-effect of antiretroviral therapy in and appears to be caused by older drugs in the NRTI class, most especially d4T stavudine, Zerit. The only viable treatment for this often distressing and stigmatising side-effect is cosmetic surgery using injectable synthetic fillers. Loss of body fat from specific areas of the body, especially from the face, arms, legs, and buttocks.
Very few posters or presentations concerned themselves with the clinical management of lipodystrophy and in particular with reconstructive procedure to repair facial atrophy at the 4th International Workshop on Drug Reactions and Lipodystrophy in HIV Infection. The level of interest from patients, and the confusion in this area, was shown at a separate community-organised meeting held on the second evening of the Workshop. Four companies presented different approaches to a capacity audience of around patients, doctors and community advocates. One of the speakers at that meeting also provided the final talk at the Lipodystrophy Workshop and had the difficult task of summarising around 20 treatments, especially as comparative data and results from clinical studies are not available for many of these products. Dr Jones is a clinical assistant professor at UCLA and an investigator for the SilSkin studies of a new formulation of silicone oil — and his presentation tended, not surprisngly, to show preferences for this treatment.