title: Use of Topical Rapamycin in Facial Angiofibromas in Indian Skin Type.
abstract: BACKGROUND
  Facial angiofibromas (FA) are the most visible cutaneous manifestations in patients with tuberous sclerosis (TS), often resulting in stigmatization of the affected individuals. Recent studies have suggested that topical rapamycin may be an effective treatment for angiofibromas.
  
  
  OBJECTIVE
  To study the safety and efficacy of topical rapamycin in treatment of FA in Type IV-VI skin type.
  
  
  METHODS
  Five female patients with FA were included in the study, four of whom had TS, whereas one had isolated angiofibromas without systemic involvement. The age of the patients varied from 6 to 44 years. After baseline evaluation, they were advised to apply topical rapamycin (0.1-1%) in white soft paraffin base twice daily. Follow-up varied from 1 month to 6 months and is ongoing.
  
  
  RESULTS
  A sustained improvement was observed with respect to erythema, size as well as extent of the lesions as early as within 2 weeks of starting treatment. No side effects were observed. A correlation between duration of angiofibromas and effectiveness of treatment was noted.
  
  
  CONCLUSIONS
  Topical rapamycin appears to be a safe and effective alternative to surgical or laser-based treatments in patients with FA. This treatment shows potential to be a first-line management for FA and appears safe to start in early childhood.
authors.affiliation: Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India.
authors.forename: Vishalakshi
authors.initials: V
authors.lastname: Viswanath
authors.affiliation: Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India.
authors.forename: Parul
authors.initials: P
authors.lastname: Thakur
authors.affiliation: Department of Dermatology, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India.
authors.forename: Poonam
authors.initials: P
authors.lastname: Pund
keywords: Angiofibromas; topical rapamycin; tuberous sclerosis