College of Medicine, The Ohio State University, Columbus, Ohio, USA.
Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.
Pediatr Dermatol. 2024 Jan-Feb;41(1):108-111. doi: 10.1111/pde.15409. Epub 2023 Aug 12.
Port wine birthmarks (PWB) are capillary vascular malformations within the papillary and reticular dermis, most commonly occurring on the head and neck and may darken and thicken with age. Pulsed dye laser (PDL) is the gold standard of treatment for PWB as it selectively targets involved vessels. Sirolimus is a macrolide antibiotic that selectively inhibits mammalian target of rapamycin, thereby suppressing the angiogenesis pathways that can be activated by PDL. Sirolimus and PDL may be used together to treat PWB. We present a case series describing three cases of delayed ulceration and systemic sirolimus absorption following combination therapy, highlighting a potential complication and patient safety concern.
葡萄酒色斑（PWB）是位于乳头层和网状真皮内的毛细血管血管畸形，最常发生于头颈部，且可能随年龄增长而变暗、变厚。脉冲染料激光（PDL）是 PWB 的治疗金标准，因为它可以选择性地靶向受累血管。西罗莫司是一种大环内酯类抗生素，可选择性抑制雷帕霉素哺乳动物靶标，从而抑制 PDL 激活的血管生成途径。西罗莫司和 PDL 可联合用于治疗 PWB。我们报告了三例联合治疗后出现延迟性溃疡和系统性西罗莫司吸收的病例系列，强调了一种潜在的并发症和患者安全隐患。
