Extensive facial angiofibromas in tuberous sclerosis treated with carbon dioxide laserbrasion

Facial angiofibromas in systemic sclerosis cause significant cosmetic disfigurement and emotional distress. The treatment of these lesions have been a challenge because of the multiplicity of the lesions and the presence of the lesions at anatomically difficult sites. Four female patients between 12-22 years in age with extensive angiofibromas on face, nasolabial folds and chin for 2-10 years were treated with carbon dioxide (CO2) laser. The lesions in all patients were vaporized with the indigenously developed CO2 laser. All the patients were evaluated at 1 and 2 weeks and then every month for 6 months to assess the overall response to treatment and side effects. All the patients responded to the treatment and had an improvement of 50-80%. Transient erythema and hypopigmentation were seen in all the patients while post laser hyperpigmentation was seen in 2 patients. There were no other significant side effects. CO2 laser seems to be a good therapeutic tool for the treatment of extensive facial angiofibromas with good, cosmetically acceptable results even in dark (brown) skin patients with negligible side effects and minimal recurrences.