Current Options for the Treatment of Facial Angiofibromas

Salido‐Vallejo, Rafael; Garnacho‐Saucedo, Gloria; Moreno‐Giménez, J.C.

doi:10.1016/j.adengl.2014.05.001

Cited by 13 publications

(18 citation statements)

References 68 publications

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“…Procedural options for angiofibromas include radiofrequency ablation, cryotherapy, electrocoagulation, dermabrasion, and laser treatment such as AFR and PDL. 5 Reported complications such as lesion recurrence, pain, postinflammatory hyperpigmentation, and scarring, as well as the potential risks of general anesthesia, reduce the universal utility of these procedural options. 5 Several topical agents have also been used in the treatment of angiofibromas including tranilast, podophyllotoxin, and rapamycin.…”

Section: Discussionmentioning

confidence: 99%

“…5 Reported complications such as lesion recurrence, pain, postinflammatory hyperpigmentation, and scarring, as well as the potential risks of general anesthesia, reduce the universal utility of these procedural options. 5 Several topical agents have also been used in the treatment of angiofibromas including tranilast, podophyllotoxin, and rapamycin. 5 Topical rapamycin, in particular, has become a focus of TSC-related research.…”

Section: Discussionmentioning

confidence: 99%

“…5 Several topical agents have also been used in the treatment of angiofibromas including tranilast, podophyllotoxin, and rapamycin. 5 Topical rapamycin, in particular, has become a focus of TSC-related research. Rapamycin is a mechanistic target of rapamycin (mTOR) inhibitor that is commonly used as an immunosuppressant in transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…5 However, complications such as pain, postinflammatory hyperpigmentation, and scarring have reduced the utility of these treatment options. 5,6 Most notably, recurrences after these procedures have been reported in up to 80% of cases necessitating frequent, serial treatments. 6 The medication rapamycin (sirolimus) has received recent attention for its role in helping to regulate the formation of angiofibromas; it too has disadvantages, however, including limited availability and potentially prohibitive financial cost.…”

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confidence: 99%

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Inhibition of Angiofibromas in a Tuberous Sclerosis Patient Using Topical Timolol 0.5% Gel

Krakowski

Nguyen

2015

Pediatrics

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Angiofibromas are the most recognized cutaneous manifestations of tuberous sclerosis complex. Angiofibromas can be associated with disfigurement, bleeding, pruritus, and erythema and may lead to significant psychosocial consequences for affected patients. Histopathologically, angiofibromas consist of a mixture of vascular and interstitial cells. Traditional treatment options include cryotherapy, electrocoagulation, radiofrequency ablation, dermabrasion, laser treatment, and topical agents such as podophyllotoxin. However, complications such as pain, postinflammatory hyperpigmentation, scarring, and the frequent recurrence rate reduce the utility of these treatment options. The introduction of topical rapamycin marked a turning point for treatment of facial angiofibromas; however, the lack of a standardized formulation, limited insurance coverage, and significant financial cost restrict universal access for patients and their caregivers. Both oral and topical β-blockers have proven extremely effective treatments for superficial vascular tumors such as hemangiomas and pyogenic granulomas. Topical β-blockers may potentially be useful for treatment of angiofibromas considering these lesions also contain a vascular component. Here we present an exploratory case report of a patient with tuberous sclerosis complex who had significant clinical improvement of her facial angiofibromas utilizing a “split-face” comparison protocol of topical timolol 0.5% gel after full-field treatment with ablative fractional laser resurfacing and pulsed-dye laser.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Inhibition of Angiofibromas in a Tuberous Sclerosis Patient Using Topical Timolol 0.5% Gel

Krakowski

Nguyen

2015

Pediatrics

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Elucidation of the mTOR Pathway and Therapeutic Applications in Dermatology

Salido‐Vallejo

Garnacho‐Saucedo

Vélez

2016

Actas Dermo-Sifiliográficas (English Edition)

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The member of the phosphatidylinositol 3-kinase family, mammalian target of rapamycin, is involved in modulating inflammatory response and regulating cellular processes associated with growth, differentiation, and angiogenesis. Recent years have seen major advances in our understanding of the mammalian target of rapamycin signaling pathway and the implication of this pathway in multiple genetic and inflammatory diseases and tumors. The development of the mammalian target of rapamycin inhibitors has given rise to new treatment approaches that have led to substantially improved outcomes in many diseases. In this article, we review the role of the mammalian target of rapamycin signaling pathway in the different skin diseases with which it has been associated, examine the therapeutic applications of drugs targeting this pathway, and provide an overview of current trends and future directions in research.

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