Dual-mode carbon dioxide laser (continuous and fractional) with 1540 nm non-ablative fractional laser and topical sirolimus in lymphangioma circumscriptum

Lymphangioma circumscriptum (LC) is a rare lymphatic malformation majorly localized in the skin. We report a case of 12-year-old girl with LC which was simultaneously treated with carbon dioxide laser (10600 nm) and 1540 nm non-ablative fractional laser, followed by topical sirolimus during and after the procedure for a total of seven sessions. Simultaneous combination of 1540 nm non-ablative fractional and CO2 laser as a targeted therapeutic strategy for LC has been limited to one case in the past, but without the use of sirolimus. This report highlights the application and immediate outcomes of this combined use of different lasers along with topical sirolimus, underscoring its potential relevance for future clinical practice and research.