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Clinical Dermatology

Topical rapamycin in facial angiofibromas: patients satisfaction versus objective response, and a literature review

Original Article, 93 - 98
doi: 10.11138/cderm/2014.2.2.093
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Abstract
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Facial Angiofibromas (FA) are a common cutaneous manifestation of Tuberous Sclerosis (TS).
Different therapies have been employed until now (surgery, CO2 laser…) without successful and permanent effects. Recently, topical rapamycin has been reported as a new and effective treatment without significant adverse effects.
We present our experience in four adult patients with FA and TS who have been treated with 1% rapamycin ointment for three months. We evaluated the objective response achieved by using the Facial
Angiofibromas Severity Index (FASI). On the other hand, in order to know the patients’ subjective satisfaction they completed a questionnaire to evaluate this therapy.
We noticed a slight reduction of erythema, size and number of FA, lower than published in the literature.
Despite this, overall satisfaction was high or very high even if the FA reappeared months after discontinuing the application.
We wonder if this subjective response justifies the costs of this treatment nowadays, especially in adult patients in which the established fibrosis in the FA could decrease the efficacy of the ointment. We also present a review of all published cases to date.

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