A retrospective study of Q-switched Nd:YAG laser in the treatment of Hori’s naevus

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 (NdYAG) 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 NdYAG laser was carried out. Patient’s demographic data and clinical characteristics, response to Q-switched NdYAG laser, complications and recurrence were reviewed. Results A total of 16 patients diagnosed clinically with Hori’s naevus and treated with Q-switched NdYAG 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 NdYAG and five combination treatment with Q-switched 532nm NdYAG 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 NdYAG laser followed by 1064nm laser and Q-switched 1064nm NdYAG 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.