Study of efficacy of Rapamycin 0.1% cream in facial Angiofibroma – Case series

Facial angiofibroma are small, symmetrical, pink to red papules which coalesce to form plaques. It is the most frequent and highly stigmatizing cutaneous finding of Tuberous Sclerosis Complex. Our study explores the efficacy of topical rapamycin therapy for the treatment of facial angiofibroma. To study the effect and safety profile of rapamycin 0.1% cream on facial angiofibroma. Five patients of facial angiofibroma were included in this study. All patients had other cutaneous as well as systemic involvement of tuberous sclerosis complex. After baseline investigations, they were asked to apply rapamycin 0.1% cream every night and asked to follow up monthly for 6 months. Facial Angiofibroma Severity Index (FASI) was used for evaluation of lesions. All patients showed improvement in erythema, extent, and number of lesions within one month of starting therapy. No side effects were observed. There was sustained improvement on continued treatment. One patient was lost to follow up after one visit. Four patients completed 6 months therapy. One patient showed increase in size of lesions one month after stopping the therapy. Facial angiofibroma is major cosmetic concern for patients of TSC. Topical rapamycin appears to be safe and efficacious option to consider for treatment of facial angiofibroma. It is a good non-invasive modality, although continued therapy for longer duration may be needed. Further multicentric long term studies are required.