Clinical, Cosmetic and Investigational Dermatology最新文献

{"title":"Aesthetic Thermotherapy-Induced Panniculitis in a Patient with Psoriasis: A Case Report.","authors":"Ximei Ma, Lan Ying","doi":"10.2147/CCID.S628906","DOIUrl":"10.2147/CCID.S628906","url":null,"abstract":"<p><strong>Purpose: </strong>We describe a rare case of panniculitis following aesthetic thermotherapy in a patient with psoriasis, who responded well to tofacitinib. To the best of our knowledge, this is the first reported case of aesthetic thermotherapy-induced panniculitis in a patient with psoriasis.</p><p><strong>Case report: </strong>A 39-year-old female with a 4-year history of psoriasis vulgaris developed multiple subcutaneous nodules on the extremities and abdomen one month after completing a one-week course of whole-body aesthetic thermotherapy (approximately 40-50 ^<b>°</b> C, approximately one hour per session). Physical examination revealed firm, mobile, mildly tender nodules, with the largest measuring 5 cm in diameter and overlying skin appearing normal or slightly reddish. Laboratory investigations to exclude other causes of panniculitis, including autoimmune markers and infection screening, were unremarkable except for an elevated C-reactive protein level (118.6 mg/L). Ultrasound demonstrated subcutaneous inflammatory changes, and percutaneous biopsy confirmed chronic inflammation with histiocytic infiltration, consistent with panniculitis. The patient was treated with oral tofacitinib (5 mg once daily) for six months, resulting in significant clinical improvement during follow-up; the underlying psoriasis remained stable.</p><p><strong>Conclusion: </strong>Aesthetic thermotherapy can rarely induce panniculitis, especially in patients with underlying psoriasis and immune dysregulation. This case highlights the need to consider panniculitis when patients present with new subcutaneous nodules after cosmetic thermal procedures. Tofacitinib appears to be an effective treatment option.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"628906"},"PeriodicalIF":2.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stapokibart for Facial-Predominant AD-Like Dermatoses: A Retrospective Real-World Case Series Highlighting Response Heterogeneity.","authors":"Yunkai Zhu, Jingchun Chen, Peng Wang, Peiyi Feng, Xia Wang","doi":"10.2147/CCID.S632078","DOIUrl":"10.2147/CCID.S632078","url":null,"abstract":"<p><strong>Background: </strong>Facial-predominant inflammatory dermatoses are diagnostically heterogeneous and may overlap with atopic dermatitis (AD), contact dermatitis, rosacea-like inflammation, and autoimmune mimics. Stapokibart, an IL-4Rα-targeted monoclonal antibody, has demonstrated efficacy in moderate-to-severe AD, but real-world experience in facial-predominant AD-like presentations remains limited.</p><p><strong>Methods: </strong>We retrospectively reviewed five unpublished patients with facial-predominant inflammatory dermatoses treated with stapokibart in routine practice. Clinical phenotype, diagnostic work-up, prior and concomitant therapy, dosing, symptom scores, treatment course, recurrence, and adverse events were summarized descriptively. The cohort was not intended as a diagnostically uniform efficacy population, and no formal hypothesis testing was performed.</p><p><strong>Results: </strong>Five women aged 28-75 years were included. Pruritus numerical rating scale changed from a median of 3 (range, 2-4) at baseline to 1 (range, 0-3) at first follow-up; four patients improved and one worsened. All three patients with a well-supported facial-predominant AD phenotype showed rapid improvement in facial lesions and pruritus after stapokibart. One of these patients developed an injection-site reaction that led to treatment discontinuation; no serious adverse events were observed. One patient initially treated for AD-like facial dermatitis was subsequently evaluated for possible early clinically amyopathic dermatomyositis after telangiectatic and mildly atrophic features became more apparent. Another patient with an incompletely characterized AD-like facial eruption worsened on day 2 after stapokibart.</p><p><strong>Conclusion: </strong>In this small case series, rapid improvement was observed in all three patients with a well-supported facial-predominant AD phenotype, whereas atypical or incompletely characterized eruptions showed greater diagnostic complexity and variable outcomes. These preliminary observations support further investigation of stapokibart in facial-predominant AD while underscoring the need for careful phenotyping before IL-4Rα blockade.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"632078"},"PeriodicalIF":2.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isotretinoin-Associated Serum Creatinine Elevation During Acne Treatment: A Case Report.","authors":"Yi Chen, Ye-Ping Qin, Yan Li, Jing-Peng Chen, Ren-Jie Li, Ruo-Zhou Qi, Bao-Chen Zhu, Hui-Shang Feng","doi":"10.2147/CCID.S628487","DOIUrl":"10.2147/CCID.S628487","url":null,"abstract":"<p><strong>Background: </strong>Isotretinoin is first-line for moderate-to-severe acne. Its common adverse reactions involve the mucocutaneous system, liver, and lipid metabolism, while renal dysfunction is often overlooked with scarce reports.</p><p><strong>Case presentation: </strong>A 34-year-old female without prior renal dysfunction received isotretinoin 20 mg/day for acne. Serum creatinine rose after 3 weeks, reached 82.6 μmol/L by week 5, then decreased stepwise after discontinuation and normalized on follow-up. Urinary ultrasound was unremarkable.</p><p><strong>Observations and analysis: </strong>The Naranjo score was 7, indicating a probable association. Unlike previous renal adverse events presenting with dysuria, edema, flank pain, or hematuria, this case was asymptomatic, which may be attributed to individual differences in drug metabolism.</p><p><strong>Conclusion: </strong>This case report describes a mild elevation in serum creatinine that was possibly associated with isotretinoin therapy and highlights the importance of clinical awareness of potential renal function changes during treatment, particularly in patients receiving long-term therapy or concomitant medications.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"628487"},"PeriodicalIF":2.5,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Squamous Cell Carcinoma Arising Within a Mycosis Fungoides Plaque: A Case Report.","authors":"Ying Zhang, Xueying Wang, Xiaoli Jin, Yanhua Wang","doi":"10.2147/CCID.S625749","DOIUrl":"10.2147/CCID.S625749","url":null,"abstract":"<p><strong>Background: </strong>Squamous cell carcinoma (SCC) rarely develops within mycosis fungoides (MF) lesions. Recognizing a new epithelial malignancy within a longstanding MF plaque is important because clinical change may otherwise be attributed to lymphoma progression.</p><p><strong>Case presentation: </strong>A 71-year-old man with a 30-year history of MF, no prior systemic therapy, psoralen plus ultraviolet A phototherapy, or topical chemotherapy, and limited prediagnostic narrowband ultraviolet B exposure developed a rapidly enlarging ulcerated mass within a lumbar MF plaque. Histopathology showed moderately differentiated keratinizing SCC adjacent to plaque-stage MF. Immunohistochemistry demonstrated a mixed CD4/CD8 lymphoid infiltrate; Ki-67 labeling was approximately 5% in the MF lymphoid compartment and 40-50% in SCC epithelial cells. Wide local excision with 1-cm margins, bilateral advancement flaps, and full-thickness skin grafting achieved clear margins.</p><p><strong>Results: </strong>Recovery was uncomplicated, and no clinical recurrence was detected at 6 months. The surrounding MF plaques appeared less erythematous and infiltrated, although the significance of this observation is uncertain.</p><p><strong>Conclusion: </strong>A rapidly growing, ulcerated, or otherwise changing lesion within longstanding MF warrants prompt biopsy to exclude a second cutaneous malignancy. Compartment-specific interpretation of immunohistochemical findings is essential, and surgical excision can be feasible in MF-affected skin.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"625749"},"PeriodicalIF":2.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dramatic Improvement of Treatment-Refractory Prurigo Nodularis Following Initiation of Semaglutide: A Case Report.","authors":"Anne-Claire Fougerousse","doi":"10.2147/CCID.S606727","DOIUrl":"10.2147/CCID.S606727","url":null,"abstract":"<p><p>Prurigo nodularis (PN) is a chronic inflammatory dermatosis characterized by intensely pruritic hyperkeratotic nodules affecting the trunk and extremities. Despite an expanding therapeutic armamentarium including dupilumab and nemolizumab, a subset of patients remains inadequately controlled. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), widely used in the management of type 2 diabetes and obesity, have provided emerging evidence supporting immunomodulatory and anti-inflammatory effects in several chronic inflammatory dermatoses. We report the case of a 64-year-old man with severe, treatment-refractory PN who had failed multiple lines of therapy over four years, including potent topical corticosteroids, dupilumab, and methotrexate. Following initiation of semaglutide for obesity, and with no change to his background PN treatment, a dramatic and progressive clinical improvement was observed. To our knowledge, this is the first reported case of PN improvement under GLP-1 RA therapy. The potential mechanisms underlying this benefit include modulation of low-grade chronic inflammation, direct effects on GLP-1 receptor-expressing immune cells, possible modulation of Th2 immune response, and anti-nociceptive action on pruritus via central and peripheral neuro-immune pathways. This observation highlights the potential of GLP-1 RAs as adjunctive therapy in refractory inflammatory dermatoses and warrants further investigation.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"606727"},"PeriodicalIF":2.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Isolated Nail Psoriasis with JAK Inhibitor Tofacitinib: A Case Report.","authors":"Jianping Xie, Wen Luo, Chunxia Wang, Weiwei Wu","doi":"10.2147/CCID.S626741","DOIUrl":"10.2147/CCID.S626741","url":null,"abstract":"<p><strong>Background: </strong>Isolated nail psoriasis is clinically rare, characterized by nail involvement in the absence of cutaneous lesions, and is often misdiagnosed as onychomycosis. Although tofacitinib, a JAK1/JAK3 inhibitor, is approved for psoriatic arthritis, evidence regarding its efficacy and safety in isolated nail psoriasis remains limited.</p><p><strong>Case presentation: </strong>We present a 39-year-old female with a 6-year history of refractory isolated nail psoriasis, previously unresponsive to itraconazole, acitretin, topical antifungals, and corticosteroids. The patient received oral tofacitinib 5 mg twice daily and was followed up for 24 weeks. Clinical outcomes were assessed using the Nail Psoriasis Severity Index (NAPSI) and Dermatology Life Quality Index (DLQI). Following 24 weeks of treatment, nail pitting, onycholysis, subungual hyperkeratosis, and nail thickening showed marked improvement, with NAPSI decreasing from 34 to 5 (85.3% reduction) and DLQI from 22 to 2. No significant adverse events were observed throughout the treatment period.</p><p><strong>Conclusion: </strong>The present report offers preliminary evidence supporting the efficacy of a JAK inhibitor in the treatment of refractory isolated nail psoriasis. Large-scale controlled trials are warranted to confirm long-term safety and clinical efficacy.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"626741"},"PeriodicalIF":2.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological Features and Prognosis of Pediatric Mastocytosis: A 15-Year Experience with Emphasis on Disease Evolution.","authors":"Qiannan Jia, Weiqi Wang, Shuaixin Li, Xinran Li, Aiping Fan, Dian Zheng, Siying Li, Jun Li","doi":"10.2147/CCID.S631277","DOIUrl":"10.2147/CCID.S631277","url":null,"abstract":"<p><strong>Background: </strong>Mastocytosis is characterized by abnormal accumulation of mast cells in one or multiple organs. Pediatric-onset mastocytosis varies from adult type in the clinical manifestations and disease courses.</p><p><strong>Objective: </strong>To better understand the pediatric variants from adult mastocytosis, we performed a thorough study of mastocytosis subtypes.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with mastocytosis beginning at ≤17 years of age who were evaluated in the Department of Dermatology between 2009 and 2025. Diagnoses and subtype classifications were established according to the 2022 World Health Organization (WHO) diagnostic criteria. Clinicopathological features, immunophenotypes, clinical outcomes, and potential prognostic factors were analyzed.</p><p><strong>Results: </strong>Fifty-two patients were included, with a male to female ratio of 2.25:1. Maculopapular cutaneous mastocytosis (MPCM) was the most common subtype, followed by cutaneous mastocytoma, diffuse cutaneous mastocytosis (DCM) and systemic mastocytosis. Among MPCM patients, 60.47% were classified as p-MPCM and 39.53% as m-MPCM. Compared to m-MPCM, p-MPCM showed more frequent extremity involvement (P=0.0037) and laboratory abnormalities. CD2 was expressed in 74.42% of pediatric mastocytosis, while CD25 and CD30 were expressed in a few congenital lesions with high mast cell burden. Four patients (11.76%) achieved complete remission, and 11 patients (32.35%) showed partial remission, whereas 19 patients (55.88%) had persistent lesions with non-remission or worsening condition. Kaplan-Meier analysis revealed no significant association between clinicopathological variables with clinical outcome.</p><p><strong>Conclusion: </strong>Chinese pediatric patients with mastocytosis in our cohort tend to have isolated CM without systemic involvement, significant predilection for male, and persistent clinical course with limited favorable outcomes. Pediatric mastocytosis exhibited distinct clinical manifestations and immunophenotypes in contrast to adult mastocytosis and Caucasian cohorts, suggesting age-related and population-related differences in disease evolution.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"631277"},"PeriodicalIF":2.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Candidate Syndromic Triad of Acne Keloidalis Nuchae, Dissecting Cellulitis, and Secondary Cutis Verticis Gyrata.","authors":"Sanusi Umar, Ochanya Ogah, Jason Yang, Belinda H Tan, Nancy Aiead, Paul K Shitabata","doi":"10.2147/CCID.S615576","DOIUrl":"10.2147/CCID.S615576","url":null,"abstract":"<p><strong>Purpose: </strong>Acne keloidalis nuchae (AKN) affects the posterior hairline/nape; dissecting cellulitis of the scalp (DCS) is a suppurative scarring alopecia; and cutis verticis gyrata (CVG) describes scalp folds that may arise from chronic inflammation. This small retrospective, hypothesis-generating case series describes a clinicopathologically corroborated constellation of AKN, scalp-wide DCS, and extensive secondary CVG.</p><p><strong>Patients and methods: </strong>At one Los Angeles hair clinic, 12 consecutive men evaluated for suspected or confirmed DCS from December 2022 through November 2024 underwent full-scalp and posterior hairline/nape examination with trichoscopy. Triad eligibility required clinicopathologically confirmed AKN, clinicopathologically confirmed DCS involving at least 3 scalp zones, and clinically extensive CVG involving at least 3 zones. Biopsy compartments were standardized, while exact sites were selected by clinician judgment using morphology and trichoscopy.</p><p><strong>Results: </strong>Three patients met prespecified criteria (age range, 30-40 years; 2 Hispanic and 1 African American). This referral-enriched case-ascertainment observation is not a prevalence estimate. All had class II or III tumorous AKN, draining boggy nodules with scarring alopecia, and extensive cerebriform folds. Posterior hairline symptoms preceded diffuse scalp inflammation and furrowing by approximately 1-2 years. Nuchal and scalp biopsies supported AKN and DCS, respectively; clinically normal-appearing scalp biopsies showed perifollicular infundibulo-isthmic lymphocytic inflammation with fibrosis.</p><p><strong>Conclusion: </strong>The AKN-DCS-CVG constellation may represent a candidate syndromic triad characterized by high inflammatory burden and extensive fibrotic scalp remodeling. Recognition should prompt reciprocal examination of the full scalp and posterior hairline/nape. Multicenter studies are needed to validate the constellation and define its epidemiology, chronology, and clinical outcomes.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"615576"},"PeriodicalIF":2.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gluteal Calcifying Aponeurotic Fibroma: An Exceptional Location of a Rare Fibroblastic Tumour: A Case Report.","authors":"Xiaolan You, Erqiong Leng, Jun Zhang","doi":"10.2147/CCID.S620182","DOIUrl":"10.2147/CCID.S620182","url":null,"abstract":"<p><p>Calcifying aponeurotic fibroma (CAF) is a rare, benign but locally aggressive fibroblastic tumour classically involving the palms and soles of children and adolescents. Occurrence in atypical locations presents substantial diagnostic challenges. Gluteal involvement of CAF is exceedingly rare, we report a case of CAF arising in the gluteal region of a man in his twenties who presented with a four-year history of a slow-growing mass and recent pulling pain. Physical examination revealed a firm, ill-defined, deeply adherent mass with a striking gritty texture on palpation and scattered white spots on the overlying skin. Ultrasonography demonstrated a hypoechoic subcutaneous nodule containing internal hyperechoic foci consistent with calcifications. Complete surgical excision was performed, and histopathology revealed the diagnostic triad of CAF. At the 9-month follow-up (prior to submission), no recurrence or complications were observed, and the patient had returned to normal activities. This case highlights that CAF can occur in non‑acral sites such as the buttock, expanding the differential diagnosis of calcified subcutaneous nodules in young adults. The characteristic gritty texture may provide a valuable bedside diagnostic clue. Complete surgical excision with clear margins remains the mainstay of treatment.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"620182"},"PeriodicalIF":2.5,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical Sirolimus Gel for the Treatment of Superficial Microcystic Lymphatic Malformations in Pediatric Patients: A Case Series.","authors":"Xiangxiang Cui, Lulu Tang, Ke Ma, Qiufang Qian","doi":"10.2147/CCID.S621070","DOIUrl":"10.2147/CCID.S621070","url":null,"abstract":"<p><strong>Background: </strong>Superficial microcystic lymphatic malformations (MLMs) can cause persistent lymphatic leakage, bleeding, recurrent infection, and disfigurement. Conventional treatments, including surgical excision and sclerotherapy, are invasive and may result in scarring or incomplete resolution. Topical sirolimus may offer a localized, mechanism-based alternative with potentially limited systemic exposure.</p><p><strong>Objective: </strong>To describe the clinical response and safety of 0.2% topical sirolimus gel in pediatric patients with superficial MLMs.</p><p><strong>Methods: </strong>This retrospective case series included three pediatric patients with clinically and radiologically confirmed superficial MLMs. Patients received 0.2% topical sirolimus gel twice daily for 6 months. Treatment response was assessed by two independent dermatologists based on clinical examinations and serial clinical photographs, including changes in lesion size, color, thickness, bleeding, exudation, pain, pigmentation, and surface texture. Improvement was categorized as none (0%), minimal (1-25%), moderate (26-50%), or marked (>50%). Safety assessments included local and systemic adverse events and serum sirolimus concentrations.</p><p><strong>Results: </strong>All three patients were classified as having marked improvement (>50%), with reductions in lesion size and thickness, fading of pigmentation, decreased lymphatic leakage, and improvement in surface texture. One patient showed near-complete regression after 6months of treatment. The earliest clinical response was documented 10 days after treatment initiation in one patient. Local adverse events included transient stinging, erythema, pruritus, xerosis, and desquamation and were managed with supportive care or resolved spontaneously. Serum sirolimus concentrations measured at the assessed time points were consistently< 3.5 ng/mL in all three patients, well below the lower limit of quantification (LLOQ) and far lower than the therapeutic trough concentrations (4-12 ng/mL) associated with oral sirolimus therapy.</p><p><strong>Conclusion: </strong>In this three-patient case series, 0.2% topical sirolimus gel was associated with greater than 50% clinical improvement and predominantly mild local adverse events. Larger controlled studies using standardized and independently assessed outcomes are needed to establish efficacy and long-term safety.</p>","PeriodicalId":10447,"journal":{"name":"Clinical, Cosmetic and Investigational Dermatology","volume":"19 ","pages":"621070"},"PeriodicalIF":2.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}