{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:22:49Z","timestamp":1790367769949,"version":"4.1.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>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\u201337 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.<\/jats:p>","DOI":"10.1055\/a-2306-0962","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:20:45Z","timestamp":1713226845000},"page":"372-377","source":"Crossref","is-referenced-by-count":3,"title":["A Triple Laser Combination Treatment for Facial Angiofibromata Management in Tuberous Sclerosis and Literature Review"],"prefix":"10.1055","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2432-0917","authenticated-orcid":false,"given":"F.","family":"Neamonitou","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, General Anticancer Oncological Hospital of Athens \u2018Saint Savvas\u2019, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2260-6495","authenticated-orcid":false,"given":"K.K.","family":"Neamonitos","sequence":"additional","affiliation":[{"name":"Department of Dermatology, General University Hospital of Athens \u2018Attikon\u2019, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9635-7869","authenticated-orcid":false,"given":"S.","family":"Stavrianos","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, General Anticancer Oncological Hospital of Athens \u2018Saint Savvas\u2019, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8494-5583","authenticated-orcid":false,"given":"K.P.","family":"Neamonitos","sequence":"additional","affiliation":[{"name":"Hellenic Society of Dermatology Surgery (HSDS), Private Dermatological Clinic \u2018Laserderm Academy\u2019, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.pedhc.2006.05.004","article-title":"Tuberous sclerosis complex: a review","volume":"21","author":"A K Leung","year":"2007","journal-title":"J Pediatr Health Care"},{"issue":"13","key":"ref2","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1056\/NEJMra055323","article-title":"The tuberous sclerosis complex","volume":"355","author":"P B Crino","year":"2006","journal-title":"N Engl J Med"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1159\/000079605","article-title":"Bilateral and multiple periungual fibromas as an oligosymptomatic form of tuberous sclerosis","volume":"209","author":"R 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of postoperative wound healing and side-effect rates","volume":"29","author":"E L Tanzi","year":"2003","journal-title":"Dermatol Surg"},{"key":"ref11","first-page":"648","volume-title":"Total Burn Care","author":"D N Herndon","year":"2018","edition":"5th ed."},{"issue":"05","key":"ref12","first-page":"557","article-title":"The pulsed-dye laser for treatment of cutaneous conditions","volume":"144","author":"E F Bernstein","year":"2009","journal-title":"G Ital Dermatol Venereol"},{"issue":"08","key":"ref13","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1111\/ced.12398","article-title":"Facial Angiofibroma Severity Index (FASI): reliability assessment of a new tool developed to measure severity and responsiveness to therapy in tuberous sclerosis-associated facial angiofibroma","volume":"39","author":"R Salido-Vallejo","year":"2014","journal-title":"Clin Exp 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a dark-skinned patient","volume":"46","author":"K Fischer","year":"2001","journal-title":"Ann Plast Surg"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"826","DOI":"10.3390\/biomedicines10040826","article-title":"Efficacy and safety of topical mechanistic target of rapamycin inhibitors for facial angiofibromas in patients with Tuberous Sclerosis Complex: a systematic review and network meta-analysis","volume":"10","author":"Y-T Lin","year":"2022","journal-title":"Biomedicines"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"19","DOI":"10.4274\/turkderm.galenos.2019.13845","article-title":"Treatment of tuberous sclerosis facial angiofibromas with erbiumyttrium aluminium garnet laser and topical sirolimus 0.25%","volume":"54","author":"A Botsal\u0131","year":"2020","journal-title":"TURKDERM"}],"container-title":["Archives of Plastic 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