The Vanishing Face: Clinical Presentation of Hemifacial Atrophy and Its Dental Implications

Rishi Tyagi, Amit Khatri, Deepak Khandelwal, Aman Kumar, Harshita Bisht, Urvi Bhatia

Abstract: Hemifacial atrophy is a rare, acquired, neurocutaneous syndrome characterised by a progressive but self-limiting atrophy of the skin and subcutaneous tissue on one side of the face. Early diagnosis and a multidisciplinary approach are essential to prevent worsening of functional and aesthetic complications. We report the case of a 13-year-old male presenting with unilateral facial atrophy accompanied by firm, hyperpigmented plaques aligned along Blaschko?s lines on the right side of the face. Diagnostic evaluations, including serology and imaging, confirmed the diagnosis of linear morphea en coup de sabre. Histopathological analysis revealed dermal fibrosis with lymphocytic infiltration. Dental examination identified irreversible pulpitis in the lower right first permanent molar, attributed to skeletal and dental asymmetry. Root canal treatment was performed, followed by prosthetic rehabilitation using a custom 3D-printed zirconia endocrown. Concurrently, the patient received topical tacrolimus as part of dermatologic management. This case highlights the significance of early recognition and coordinated care in patients with linear scleroderma involving craniofacial structures. Dental practitioners play a vital role in managing oral complications and preserving function and aesthetics in such patients. Multidisciplinary collaboration is essential to improve outcomes and quality of life.

Keywords: Blaschko lines, Progressive facial hemiatrophy, Morphea, CAD/CAM Endocrown

How to Cite?: Rishi Tyagi, Amit Khatri, Deepak Khandelwal, Aman Kumar, Harshita Bisht, Urvi Bhatia, "The Vanishing Face: Clinical Presentation of Hemifacial Atrophy and Its Dental Implications", Volume 14 Issue 11, November 2025, International Journal of Science and Research (IJSR), Pages: 129-133, https://www.ijsr.net/getabstract.php?paperid=SR251105211958, DOI: https://dx.doi.org/10.21275/SR251105211958