DERMATOLOGICAL MANIFESTATIONS AND SURGICAL APPROACH IN PATIENTS WITH SYSTEMIC SCLEROSIS: PERSPECTIVES FROM PLASTIC SURGERY AND RHEUMATOLOGY

Abstract

Introduction: Systemic sclerosis, a complex autoimmune disease, causes significant dermatological manifestations that impact the quality of life of patients. Cutaneous fibrosis, vascular alterations and skin lesions are common, requiring a multidisciplinary approach involving both rheumatology and plastic surgery. Surgical techniques can offer relief and aesthetic improvement, but the interaction between immunological aspects and healing needs to be carefully considered. With the increase in understanding of the pathology, new perspectives for the surgical treatment of dermatological manifestations emerge. Objective: To evaluate surgical approaches for dermatological manifestations in patients with systemic sclerosis, examining the intersection between plastic surgery practices and rheumatology principles. Methodology: The research was conducted using the PRISMA checklist, and the PubMed, Scielo and Web of Science databases were consulted. Five main descriptors were selected: "systemic sclerosis", "dermatological manifestations", "plastic surgery", "rheumatology" and "surgical treatment". The inclusion criteria included articles published in the last ten years, studies that addressed surgical interventions in dermatology and research involving systemic sclerosis. The exclusion criteria were articles in languages ​​other than Portuguese or English, publications that did not discuss surgeries and studies that did not involve human patients. Results: The review identified several surgical techniques, such as excision of skin lesions, the use of grafts and laser therapy, highlighting their efficacy in improving the appearance and function of the skin. The findings emphasized the importance of preoperative evaluation and management of complications, since healing in patients with systemic sclerosis is often compromised. Concerns related to safety and postoperative management were also addressed. Conclusion: Surgical approaches to the dermatologic manifestations of systemic sclerosis have shown promise, providing aesthetic and functional benefits. However, collaboration between rheumatologists and plastic surgeons is essential to optimize outcomes and minimize complications. This interaction can enhance the overall management of patients, ensuring that interventions are tailored to individual needs. Continued research in this field is crucial to improve clinical practices and provide more effective care.