Recurrent lymphangioma circumscriptum: Treated with microneedling radiofrequency and topical sirolimus

Abstract Introduction: Lymphangioma circumscriptum is a “microcytic” lymphatic malformation. Different treatments have been tried with varying success. We report here a case of recurrent lymphangioma circumscriptum who was treated with microneedling radiofrequency (MNRF) and topical preparation or sirolimus cream with good improvement. Case Report: A 14-year-old girl presented to outpatient department with a cluster of small asymptomatic blisters over the unilateral inguinal area which on histopathology was confirmed to be lymphangioma circumscriptum. The patient had similar lesions 3 years back which she got surgically excised. Since the last 6 months, she had a recurrence of the similar lesions so this time we chose MNRF every 40 days to treat this case which was combined with topical sirolimus 0.01% during and after the procedure. Discussion: MNRF helps in neoelastogenesis and neocollagenosis, which leads to dermal thickening. It also acts as a drug delivery system by creating dermal channels. Sirolimus with its antilymphangiogenic properties helps prevent recurrence.