Treatment of superficial vascular anomalies with topical sirolimus: A multicenter case series

Melissa Dodds, Megha Tollefson, Leslie Castelo-Soccio, Maria C. Garzon, Marcia Hogeling, Kristen Hook, Christina Boull, Sheilagh Maguiness

Research output: Contribution to journalArticle


Background: Systemic sirolimus (rapamycin) has recently been found effective in treating complex vascular anomalies by reducing the size and associated complications. Many vascular anomalies have a cutaneous component, and thus, we sought to determine whether topical administration of sirolimus may be an effective therapy, as data on the use of topical sirolimus are limited. Objective: We reviewed the efficacy and tolerability of topical formulations of sirolimus in the treatment of various simple and combined vascular malformations and tumors. Methods: Eighteen patients with any vascular anomaly treated exclusively with topical sirolimus were retrospectively reviewed. Results: Eleven patients had combined venous lymphatic malformations, three had tufted angiomas, two had a lymphatic malformation, one had a venous malformation, and one had a verrucous venous malformation. All (100%) patients reported some degree of improvement and 50% of patients reported marked improvement in one or more symptoms, most commonly blebs and lymphatic drainage, and bleeding. Limitations: The retrospective nature, small number of patients, and differences in topical preparations limit the broad application of the results. Conclusion: Topical sirolimus appears to be a safe and useful non-invasive therapy that is well-tolerated in the treatment of the cutaneous portion of a variety of vascular anomalies.

Original languageEnglish (US)
JournalPediatric Dermatology
StateAccepted/In press - Jan 1 2020



  • genetic diseases/mechanisms
  • hemangiomas/vascular tumors
  • therapy topical
  • vascular malformation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Dermatology

Cite this

Dodds, M., Tollefson, M., Castelo-Soccio, L., Garzon, M. C., Hogeling, M., Hook, K., Boull, C., & Maguiness, S. (Accepted/In press). Treatment of superficial vascular anomalies with topical sirolimus: A multicenter case series. Pediatric Dermatology.