Combination Therapy For Angiofibromas Shows Promise

A combination of vascular laser, ablative fractional laser and topical treatment provided significant improvement in angiofibromas with no adverse events or scarring in a case study presented by Roy G. Geronemus, MD and Yoon-Soo Cindy Bae-Harboe, MD. The manuscript, “Targeted Topical and Combination Laser Surgery for the Treatment of Angiofibromas” was published in the November 2013 issue of Lasers in Surgery and Medicine.

Drs. Geronemus and Bae-Harboe treated a 26-year-old patient, suffering from angiofibromas, with the 595nm Vbeam Perfecta to address redness, the Fraxel re:pair ablative fractional laser to improve texture followed by electrosurgery on papular fibrotic lesions, and twice-daily topical sirolimus 0.2% ointment to prolong the effects of the laser treatments.

The patient reported that previous treatment with a CO2 laser offered only minimal improvement. Following the combination treatment she experienced improvement in both the number and appearance of her facial angiofibromas and erythema with no scarring or adverse events.

The researchers note that, “The presented combination treatment may prevent untoward risks (and prolong the effects) of laser surgery alone with targeted therapy using topical sirolimus. Our patient successfully underwent laser treatment in combination with topical sirolimus treatment without side effects. The patient continues to use topical sirolimus twice daily with no recurrence of her facial angiofibromas.”

J. Stuart Nelson, MD, PhD, editor-in-chief of Laser in Surgery and Medicine, commented on the study, “The angiofibromas of Tuberous Sclerosis (TS) is a frustrating, persistent, recurrent skin problem with very limited treatment options. In the manuscript, the authors explore the potential benefits of merging novel topical agents with laser surgery to increase penetration of targeted therapy into the site of pathology. This report compels investigators to study this procedure in larger randomized clinical trials so that patients suffering from the stigma of these lesions can be effectively treated.”

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