Facial angiofibromas of tuberous sclerosis: successful treatment with podophyllin

Abstract

moderate cosmetic results, but they frequently lead to scarring and pigmentation changes. 3 Surgical therapy presents immediate resolution, but causes discomfort and oedema for few days and patients need to be hospitalized.Podophyllin, is a plant alkaloid obtained from the dried roots of the may apple or mandrake (Podophyllum peltatum). It crosses cell membranes and interferes with cell replication and works as a keratolytic that causes arrest of cell mitosis in metaphase. It is often used for the treatment of genital warts. In Europe, it is used also in the treatment of actinic keratosis with good results. We preferred podophyllin to other modalities of treatment because of the easy availability and application, lack of pain, and no need for hospitalization. No scarring, infection, or other adverse events were observed in our patient. Patient satisfaction with this method was high due to rapid healing time, easy wound care.M Türkmen,* 0 Ertam, 0 Ünal, T Dereli

A Novel Topical Rapamycin Cream for the Treatment of Facial Angiofibromas in Tuberous Sclerosis Complex

“…Facial angiofibromas are more common in late childhood or adolescence, are the cause of significant morbidity, and historically have been resistant to medical and surgical treatments. [2][3][4][5][6] The authors describe here a novel rapamycin cream formulation that is easy to prepare by a community compounding pharmacy, is of cosmetic quality, is liked by patients, and is effective without systemic absorption and subsequent side effects.…”

Long-Term Exposure and Safety of a Novel Topical Rapamycin Cream for the Treatment of Facial Angiofibromas in Tuberous Sclerosis Complex: Results From a Single-Center, Open-Label Trial

“…Surgical [5][6][7]9 Medical 2,5,8,[12][13][14][15][16]21 Electrocoagulation Liquid nitrogen Electrodesiccation and curettage l3-Cis-retinoic acid (topical) Dermabrasion Podophyllin (topical) Excision Rapamycin (topical) Cryosurgery Laser (CO 2 , argon, pulse dye)…”

“…These lesions are usually the cause of significant morbidity and historically have been resistant to medical and surgical treatments. [5][6][7][8][9] Previously, 2 of the authors (J.W. and A.H.) developed a novel topical rapamycin cream for treatment of facial angiofibromas in tuberous sclerosis complex.…”

“…These lesions are usually the cause of significant morbidity and historically have been resistant to medical and surgical treatments. 5 –9…”

Use of topical rapamycin in facial angiofibromas in Indian skin type

“…Various treatment modalities used include vascular lasers, ablative lasers, and destructive techniques such as electrocautery, radiofrequency, cryotherapy, dermabrasion, and topical podophyllotoxin. [ 4 ] These can be painful, uncomfortable and recurrences are common. Surgical approaches may lead to scarring.…”