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Palmetun Ekbäck et al. Topical rapamycin tuberous sclerosis clinical practice

A B

Figure 2: Patient 4. (A) before treatment; (B) after 7 months

A B

C D E F

Figure 3: Patient 8. (A) 3 months after CO 2 laser and before rapamycin; (B) 3 months after CO 2 laser and before rapamycin close-up; (C)
after 6 weeks on rapamycin; (D) after 9 months with topical rapamycin; (E) after 9 months on topical rapamycin close-up; (F) after 2 years

We could not see any difference in improvement is important knowledge for clinicians, parents and
in patients who had received CO 2 laser treatment patients. We used an oral solution with rapaymcin
compared with patients who had not. because it was impossible at that time to get an ex
tempore ointment prepared in a Swedish pharmacy.
DISCUSSION We had an overall improvement of 70% which is
a lower figure than what has been reported in the
This is a retrospective observational study reflecting literature, where the majority reported improvement,
our experience in clinical practice using topical which might be because of less application in our
rapamycin. The solution was not applied daily because group of patients. [5,7,11,12,14,18] The patients, with lowest
of side effects but also because of compliance response in our clinical setting, were the patients with
problems, but we still had good clinical effect. This papules and nodules. Park et al. [15] found that papules

Plastic and Aesthetic Research ¦ Volume 3 ¦ October 25, 2016 331