{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T19:11:11Z","timestamp":1778785871109,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,5,23]],"date-time":"2018-05-23T00:00:00Z","timestamp":1527033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Efficacy of topical sirolimus has recently been described in lymphatic anomalies but not in other types of vascular anomalies. To our knowledge, systemic absorption of topical sirolimus in these lesions has not yet been reported. The objective was to evaluate the efficacy, tolerance, and absorption of topical sirolimus 0.1% with different types of vascular anomalies in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sirolimus 0.1% was applied on cutaneous vascular anomalies in six children aged 2\u201017. These anomalies consisted of three extratruncular micro\u2010 and macrocystic lymphatic malformations and one each verrucous venous malformation, truncular lymphatic malformation with angiokeratomas, and infantile hemangioma. Sirolimus blood levels were measured after 1\u00a0week, 1\u00a0month, and 3\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A rapid decrease in the size of superficial lymphatic malformations in three of six patients and a significant decrease in discharge from oozing lesions were observed. Response occurred in less than 3\u00a0months. The truncular lymphatic malformation, verrucous venous malformation, and infantile hemangioma did not respond to topical sirolimus. Sirolimus levels were undetectable. Adverse effects were limited to local irritation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Topical sirolimus 0.1% is a useful treatment for cutaneous manifestations of extratruncular lymphatic malformations. The only adverse effect is local irritation. No systemic effects are expected, because blood levels are clinically insignificant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.13547","type":"journal-article","created":{"date-parts":[[2018,5,23]],"date-time":"2018-05-23T09:20:29Z","timestamp":1527067229000},"page":"472-477","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Efficacy and absorption of topical sirolimus for the treatment of vascular anomalies in children: A case series"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9771-7715","authenticated-orcid":false,"given":"Sophie","family":"Le Sage","sequence":"first","affiliation":[{"name":"Faculty of Medicine Centre Hospitalier Universitaire Sainte\u2010Justine Universit\u00e9 de Montr\u00e9al Montr\u00e9al QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mich\u00e8le","family":"David","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology Centre Hospitalier Universitaire Sainte\u2010Justine Universit\u00e9 de Montr\u00e9al Montr\u00e9al QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9e","family":"Dubois","sequence":"additional","affiliation":[{"name":"Department of Radiology Centre Hospitalier Universitaire Sainte\u2010Justine Universit\u00e9 de Montr\u00e9al Montr\u00e9al QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Powell","sequence":"additional","affiliation":[{"name":"Division of Dermatology Centre Hospitalier Universitaire Sainte\u2010Justine Universit\u00e9 de Montr\u00e9al Montr\u00e9al QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine C.","family":"McCuaig","sequence":"additional","affiliation":[{"name":"Division of Dermatology Centre Hospitalier Universitaire Sainte\u2010Justine Universit\u00e9 de Montr\u00e9al Montr\u00e9al QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves","family":"Th\u00e9or\u00eat","sequence":"additional","affiliation":[{"name":"Department of Pharmacology Centre Hospitalier Universitaire Sainte\u2010Justine Universit\u00e9 de Montr\u00e9al Montr\u00e9al QC Canada"},{"name":"Clinical Pharmacology Unit Centre Hospitalier Universitaire Sainte\u2010Justine Universit\u00e9 de Montr\u00e9al Montr\u00e9al QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niina","family":"Kleiber","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Centre Hospitalier Universitaire Sainte\u2010Justine Universit\u00e9 de Montr\u00e9al Montr\u00e9al QC Canada"},{"name":"Clinical Pharmacology Unit Centre Hospitalier Universitaire Sainte\u2010Justine Universit\u00e9 de Montr\u00e9al Montr\u00e9al QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,5,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23124"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-3673"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-3257"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.clpt.6100317"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2011.00051"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)05412-5"},{"key":"e_1_2_6_8_1","first-page":"1541","article-title":"Modulation of hypoxia\u2010inducible factor 1alpha expression by the epidermal growth factor\/phosphatidylinositol 3\u2010kinase\/PTEN\/AKT\/FRAP pathway in human prostate cancer cells: implications for tumor angiogenesis and therapeutics","volume":"60","author":"Zhong H","year":"2000","journal-title":"Cancer Res"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25422"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.13419"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.12787"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5178.105488"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12665"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.3545"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-017-0174-5"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.3697"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2105"},{"key":"e_1_2_6_18_1","volume-title":"Lymphedema: A Concise Compendium of Theory and Practice","author":"Byung\u2010Boong Lee JB","year":"2011"},{"key":"e_1_2_6_19_1","unstructured":"Pfizer.Rapamune U.S. physician prescribing information 2017(online).https:\/\/www.pfizer.com\/products\/product-detail\/rapamune. 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