{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:53:01Z","timestamp":1787028781546,"version":"build-2736575974"},"reference-count":53,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Systemic sclerosis (SSc) or scleroderma is a rare, systemic, autoimmune connective tissue disease. It causes increased collagen synthesis, leading to multi-organ sclerosis, including the skin and joints. Patients\u2019 overall health and quality of life are harmed dramatically. Involvement of the face and, especially, the oral opening can limit patients\u2019 ability to speak and eat, oral hygiene, and cosmetic appearance. Profhilo\u00ae (NAHYCO\u00ae) is an over-the-counter product consisting of pure hyaluronic acid. It is used to improve skin quality by increasing collagen production and adipocyte vitality. This interventional study evaluated the results of perioral injections of hyaluronic acid in terms of improved skin quality, elasticity, and increased oral opening. Patients diagnosed with SSc received an injection of one syringe of Profhilo\u00ae (2 mL of hyaluronic acid) at each of two clinic visits at one-month intervals. The oral opening was measured between the upper and lower central incisors before and after treatment. Quality of life was assessed using the modified Rodnan Skin Score and Health Assessment Questionnaire-Disability Index. A total of 14 patients received the first treatment, and 11 received the second treatment. The mean oral opening increased from 31.6 mm (range 17\u201350 mm) prior to therapy to 35.8 mm (range 21\u201356) 2 months following the second injection. Statistical analysis showed that there was a significant increase in the oral opening as observed one week (36.2 mm, p = 0.011), one month (36.2 mm, p = 0.007), and three months (31.6 mm, p = 0.023) after the second injection, at the 5-month follow-up. Treatment of SSc patients\u2019 perioral area with Profhilo\u00ae can result in significant improvements in oral opening and quality of life.<\/jats:p>","DOI":"10.3390\/life13112176","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:44:18Z","timestamp":1699317858000},"page":"2176","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Treatment of Scleroderma-Related Microstomia Using Hyaluronic Acid: An Interventional Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Ofir","family":"Shir-az","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428164, Israel"},{"name":"The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3705-5454","authenticated-orcid":false,"given":"Ariel","family":"Berl","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428164, Israel"},{"name":"The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8435-8848","authenticated-orcid":false,"given":"Din","family":"Mann","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428164, Israel"},{"name":"The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biader Samih","family":"Bilal","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428164, Israel"},{"name":"The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yair","family":"Levy","sequence":"additional","affiliation":[{"name":"The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Department of Internal Medicine E, Meir Medical Center, Kfar Saba 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avshalom","family":"Shalom","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Meir Medical Center, Kfar Saba 4428164, Israel"},{"name":"The Tel Aviv Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1002\/art.40799","article-title":"Ulnar Artery Occlusion and Severity Markers of Vasculopathy in Systemic Sclerosis: A Multicenter Cross-Sectional Study","volume":"71","author":"Coiffier","year":"2019","journal-title":"Arthritis Rheumatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1016\/S0140-6736(17)32594-1","article-title":"Systemic sclerosis: Advances and prospects","volume":"390","author":"Lancet","year":"2017","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"360","DOI":"10.3389\/fphar.2019.00360","article-title":"Innovations in the Assessment of Primary and Secondary Raynaud\u2019s Phenomenon","volume":"10","author":"Ruaro","year":"2019","journal-title":"Front. 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