Autologous Fibroblast Cells in Platelet-Rich Plasma Injection as a Novel Treatment for Inactive En Coup de Sabre Deformity.

Morphea is a chronic autoimmune condition characterized by sclerosis and scar-like changes in the skin and underlying tissues. En coup de sabre represents a rare and severe linear variant of morphea, primarily affecting the frontoparietal scalp and forehead, with a higher prevalence among children and women. The disease often leads to significant cosmetic and functional impairments, posing therapeutic challenges due to its unpredictable course and varying responses to conventional treatments. Current management strategies include topical steroids, calcineurin inhibitors, systemic therapies, such as methotrexate, and ultraviolet (UV) therapy. Additionally, interventions like fat grafting and hyaluronic acid injections have demonstrated some efficacy in restoring tissue volume and improving skin texture. This case report explores an innovative approach using autologous fibroblast cell injection combined with platelet-rich plasma (PRP) as a novel therapeutic option for a 40-year-old woman diagnosed with inactive-phase en coup de sabre. After harvesting fibroblast cells from a superficial skin biopsy and isolating PRP through centrifugation, the combined solution was administered via three monthly subcutaneous injections. No adverse effects were observed throughout the treatment period. At a 3-month follow-up, significant improvements were noted in skin elasticity, hydration, and overall cosmetic appearance. Ultrasound imaging revealed enhanced dermal thickness and density, while cutometric and colorimetric assessments confirmed increased skin viscoelastic properties and brightness. The promising results observed in this case suggest that the combination of autologous fibroblasts and PRP may offer a safe, effective, and minimally invasive therapeutic alternative for managing en coup de sabre morphea. However, larger studies and controlled clinical trials are essential to validate these findings, optimize treatment protocols, and further understand the underlying mechanisms driving tissue regeneration and repair in morphea.