ABSTRACT
Background Hori’s naevus is an acquired bilateral naevus of Ota-like macules (ABNOM). It was first reported by Hori et al in 1984. It is common among Asians and has a female preponderance. Hori’s naevus is characterised by blue-brown macules typically on the malar region of the face. Objectives To evaluate the clinical characteristics of patients with Hori’s naevus seen at Hospital Kuala Lumpur and the efficacy of Qswitched neodynium-yttrium-aluminium-garnet (Nd:YAG) laser in the treatment of this condition. Method A retrospective analysis of 16 patients diagnosed clinically with Hori’s naevus and treated with Q-switched Nd:YAG laser was carried out. Patient’s demographic data and clinical characteristics, response to Q-switched Nd:YAG laser, complications and recurrence were reviewed. Results A total of 16 patients diagnosed clinically with Hori’s naevus and treated with Q-switched Nd:YAG laser were reviewed. Fifteen of the patients were female with one male. Their ages ranged from 33-61 years old (mean age = 47). Nine of these patients were Chinese with seven Malays. All had Fitzpatrick skin phototype IV. The age of onset ranged from 15-45 years old. The most common clinical presentation was bilateral brown macules on the malar region of the face. Eleven patients received treatment with Q-switched 1064nm Nd:YAG and five combination treatment with Q-switched 532nm Nd:YAG followed by 1064nm laser. Two patients were lost to follow up after a single treatment. After a single treatment, 13 patients graded their clinical response as ‘poor’ (0-25% improvement) and 1 as ‘fair’ (26-50% improvement). Six patients received a total of two treatments of whom 4 graded their response as ‘fair’ (26-50% improvement) and 2 as ‘good’ (51-75% improvement). Two patients who received a total of four treatments graded their responses as ‘good’ and ‘excellent’ (76-100% improvement) respectively. 10 patients had significant hyperpigmentation post laser treatment. However, none reported any recurrences. Conclusion There is no difference in pigment clearance between concurrent use of Q-switched 532nm Nd:YAG laser followed by 1064nm laser and Q-switched 1064nm Nd:YAG laser for Hori’s naevus. However, there is only minimal improvement after a single treatment, and multiple sessions are required to achieve satisfactory improvement. Post inflammatory hyperpigmentation was the main complication seen.
ABSTRACT
Background Naevus of Ota was first described in 1939 by Ota M. It is characterized by a bluish-gray mottled hyperpigmentation in the distribution of the trigeminal nerve. It affects between 0.014 - 0.6% of the Asian population. It is not only physically disfiguring but may be associated with tremendous psychosocial impact on the patient. The aim of the study is to determine the demographic data of local patients with naevus of Ota, their response to treatment with Q-switched 1064nm Nd:YAG laser, complications and recurrence. Materials and Methods A retrospective analysis of all patients with naevus of Ota treated with Q-switched 1064nm Nd:YAG laser between January 1998 to December 2007 was conducted at the dermatology clinic, Kuala Lumpur Hospital. Patients’ demographic data, clinical characteristics, response to Q-switched 1064nm Nd:YAG laser and the complications were reviewed. Results A total of 50 patients with naevus of Ota were treated with Q-switched 1064nm Nd:YAG laser. There were 42 female and 8 male patients with a F : M ratio of about 5:1. The mean age of presentation was 31 years old (11-60 years). More than half were Chinese patients (56%) followed by Malays (38%), Indian (2%) and others (4%). Seventy four percent of the patients had Fiztpatrick skin-type IV and the rest skin type V. Ninety two percent of the patients had unilateral trigeminal dermatomal involvement while 8% had bilateral trigeminal dermatomal involvement. Of the 15 patients who were referred to the ophthalmologist, 10 were found to have scleral involvement and none had glaucoma. Patients who had 2 treatments (13 patients) did not have any significant lightening of their lesions. In the remaining 37 patients who had 3 sessions (mean = 5.7, range 3 -15 sessions), 9 patients (24.3%) reported the response as good (51-75% lightening); 17 patients (45.3%) as excellent (>75% lightening) and 8 patients (22%) had near complete lightening (>90%). None reported any complications or recurrence. Conclusion Q-switched 1064nm Nd:YAG laser is an effective and safe treatment modality for patients with naevus of Ota.