Sarah was diagnosed with a localised form of a skin condition called morphea in which there are well demarcated plaques of fibrosis restricted to the skin. In her case this affects the right side of her nose and the top of the right side of her forehead. Recently she has had surgery in which fat from her stomach was injected into the right side of her nose and her forehead and the cheekbones. Doctors have explained that she will need several similar operations before they reconstruct her nose an
At the age of 7 Sarah was diagnosed with a localised form skin condition called morphea in which there are well demarcated plaques of fibrosis restricted to the skin. In Sarah’s case this affects the right side of her nose and the top of the right side of her forehead. It started with a line going down her nose and her GP referred her to the local hospital. Doctors explained to her and her parents that morphea is an ‘inflammation of the body’ and said that basically they couldn’t treat it. She was referred to a team in London and she was put on steroids, methatrexate and folic acid. Currently she is on methatrexate and folic acid.
At the age of 13 years she was told that it was possible to have surgery to correct the right side of her nose and forehead. Sarah had to wait till this year, 2007 when she was 16 years old to have her surgery. Initially Sarah had mixed feelings about her operation; on the one hand she was happy that something could be done about her condition but on the other hand she was also scared about the outcome of her surgery. What the surgery team did was to remove fat from her stomach and inject it into the right side of her nose and her forehead and the cheekbones. Sarah remembers that after her surgery her face looked really big but the swelling has gradually gone down. Sarah has been told that this surgical procedure will need to be repeated several times until enough fat is retained in those parts of her face that have been affected by the morphea. After that she will have further surgery to shape the right-side of her nose with cartilage from either her ear or her ribs to bridge the nose back up. Her team in London has also told her that they will try and build up the bone in her forehead or put a metal plate inside.
Sarah continues to have regular appointments with her specialist team in London which consists of her dermatology consultant, a rheumatology consultant, a plastic surgeon, and a maxi facial consultant/ ENT (ear, nose and throat) consultant. She also has thermography (a test that shows the blood flow in her face) and ultrasound tests every time she goes to London. These tests have revealed that morphea is still active in her forehead but no longer on her nose.
The prospect of more surgery does not worry Sarah and she is happy and confident about it because she knows that doctors can do something to help her. She is already on the waiting list for her next operation.