Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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A Triple Laser Combination Treatment for Facial Angiofibromata Management in Tuberous Sclerosis and Literature Review

  • F. Neamonitou (Department of Plastic Surgery, General Anticancer Oncological Hospital of Athens 'Saint Savvas') ;
  • K.K. Neamonitos (Department of Dermatology, General University Hospital of Athens 'Attikon') ;
  • S. Stavrianos (Department of Plastic Surgery, General Anticancer Oncological Hospital of Athens 'Saint Savvas') ;
  • K.P. Neamonitos (Hellenic Society of Dermatology Surgery (HSDS), Private Dermatological Clinic 'Laserderm Academy')
  • Received : 2023.07.20
  • Accepted : 2024.04.09
  • Published : 2024.07.15
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Abstract

Angiofibromas are a common facial manifestation of tuberous sclerosis (TS). However, current treatments have proven ineffective due to high recurrence rates and noncompliance. To address this issue, we developed a new triple laser therapy protocol for more effective management of angiofibromas. We conducted tests to validate its efficacy. This is a prospective study of 10 patients with TS (4 women and 6 men, mean age 26.3 years [15-37 years]) with angiofibromata who received triple sequential laser therapy at our private dermatological clinic conducted from January 2000 to December 2022. We evaluated the outcome with the Facial Angiofibromata Severity Index (FASI) via clinical photography (0, 6 months, 1 year, and 2 years), and Dermatology Life Quality Index (DLQI). All patients had a successful recovery without any complications. Among these 10 patients, 4 experienced localized recurrences at their 6-month follow-up. These recurrences were treated with a second single carbon dioxide laser session. After 2 years of follow-up, we observed no recurring facial cutaneous manifestations. Furthermore, all patients experienced a decrease in their FASI score after treatment. According to the Visual Analogue Scale, patients reported 95% satisfaction, and DLQI indicated only a minor impact on their everyday lives. We believe that this protocol of three-step laser treatment is effective, safe, and compliable for patients with facial angiofibromata, providing a satisfactory outcome adaptable to the daily dermatological and plastic surgery practice.

Keywords

Acknowledgement

We would like to thank Dr. Vasiliki Koukou, for her clinical experience and contribution as a pediatrician for diagnosing and referring many TS patients to our clinic.

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