Laser-based combo therapy effective for angiofibroma

A new study suggests that laser technology combined with a new topical therapy is effective in treating angiofibromas, characteristically seen in patients with tuberous sclerosis.

Roy G. Geronemus, M.D., and Yoon-Soo Cindy Bae-Harboe, M.D., used electrosurgery, pulsed dye laser treatment, and ablative fractional resurfacing, along with a new targeted therapy, topical sirolimus, the application of which works synergistically with laser surgery and prolongs the effects of treatment.

“The most significant finding was the enhanced effects of laser surgery by adding a novel targeted topical medical therapy, sirolimus,” Dr. Geronemus, director of the Laser & Skin Surgery Center of New York, tells Dermatology Times. “Utilizing laser technology and medical innovation, treating patients with the angiofibromas of tuberous sclerosis is now easier and far more effective than we once thought possible.”

The study cites a 26-year-old Caucasian female angiofibromas patient who had undergone CO₂ laser treatment 10 years prior with minimal improvement. The patient had never been treated with topical sirolimus.

Electrosurgery was performed on papular fibrotic lesions followed by topical sirolimus 0.2 percent ointment application. The patient was instructed to use a small amount of topical sirolimus on the treated areas twice daily. Substantial improvement was noted, with no complications.

The authors noted that studies investigating the safety of topical sirolimus show that in addition to being safe, 73 percent of patients report that they “got better on treatment.” “Although these responses are not quantitative,” they wrote, “they indicate that topical treatment may be an effective adjuvant therapy to laser surgery.”

The authors also noted that there have been no randomized controlled trials comparing the use of topical sirolimus with a combination approach using lasers and topical sirolimus. “However, the combination approach is likely to be more effective for treating the papular fibrotic angiofibroma,” they wrote.

The study was published in the November issue of LSM, the journal of the American Society for Laser Medicine and Surgery.