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Use of Topical Rapamycin in Facial Angiofibromas in Indian Skin Type
Vishalakshi Viswanath1, Parul Thakur1, Poonam Pund1
1Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India.
Introduction:
Facial angiofibromas (FA) are the most visible cutaneous manifestations in patients with tuberous sclerosis (TS), often resulting in stigmatization of the affected individuals. Recent studies have suggested that topical rapamycin may be an effective treatment for angiofibromas.
Aim:
To study the safety and efficacy of topical rapamycin in treatment of FA in Type IV-VI skin type.
Materials And Methods:
Five female patients with FA were included in the study, four of whom had TS, whereas one had isolated angiofibromas without systemic involvement. The age of the patients varied from 6 to 44 years. After baseline evaluation, they were advised to apply topical rapamycin (0.1-1%) in white soft paraffin base twice daily. Follow-up varied from 1 month to 6 months and is ongoing.
Results:
A sustained improvement was observed with respect to erythema, size as well as extent of the lesions as early as within 2 weeks of starting treatment. No side effects were observed. A correlation between duration of angiofibromas and effectiveness of treatment was noted.
Conclusion:
Topical rapamycin appears to be a safe and effective alternative to surgical or laser-based treatments in patients with FA. This treatment shows potential to be a first-line management for FA and appears safe to start in early childhood.
Insights
Topical rapamycin effectively reduced facial angiofibromas (FA) in patients with darker skin types. This treatment is safe and shows promise as a first-line option for FA, even in young children.
Area of Science:
- Dermatology
- Medical Research
- Pharmacology
Background:
- Facial angiofibromas (FA) are prominent skin lesions in tuberous sclerosis (TS), causing significant social distress.
- Topical rapamycin is emerging as a potential treatment for angiofibromas.
Purpose of the Study:
- To evaluate the safety and efficacy of topical rapamycin for treating facial angiofibromas (FA) in individuals with skin types IV-VI.
- To assess rapamycin's effectiveness in a diverse age group, including children.
Main Methods:
- A study involving five female patients (ages 6-44) with FA, four with TS and one with isolated FA.
- Participants applied topical rapamycin (0.1-1%) twice daily.
- Follow-up ranged from 1 to 6 months, with ongoing observation.
Main Results:
- Significant improvements in lesion erythema, size, and extent were observed within two weeks.
- No adverse side effects were reported during the study period.
- Treatment effectiveness correlated with the duration of angiofibromas.
Conclusions:
- Topical rapamycin presents a safe and effective alternative to surgical or laser treatments for FA.
- This therapy demonstrates potential as a primary treatment for FA, suitable for early childhood application.
- Rapamycin offers a promising new management strategy for facial angiofibromas.
