Treatment of nevus of Ota with 1064 nm picosecond Nd:YAG laser: A retrospective study.

Nevus of Ota has been successfully treated by lasers. Currently, 1064 nm picosecond Nd:YAG lasers have become available for the treatment of pigmented disorders. However, there are few studies concerning the application of 1064 nm picosecond Nd:YAG laser in nevus of Ota. This study aimed to evaluate the efficacy and safety of a 1064 nm picosecond Nd:YAG laser for the treatment of nevus of Ota. We conducted a retrospective analysis of Chinese patients with nevus of Ota who had been treated with a 1064 nm picosecond Nd:YAG laser. Those who had any other laser treatment during the period of picosecond laser treatment were excluded. Via a visual analog scale for percentage of pigmentary clearance in standard photographs, the treatment efficacy was assessed by three blinded physician evaluators. A total of 16 subjects were included in this retrospective study. The average age at the beginning of treatment was 16.87 years old (range of 4 months to 59 years), and all patients were of Fitzpatrick skin type IV. Total treatment ranged from 1 to 5 sessions. A 1064 nm picosecond Nd:YAG laser with a mean fluence of 1.8-4.3 J/cm2 was used at 3-12 month intervals. The mean efficacy score for all 16 patients was 2.56 after one session, and the mean efficacy score of 13 patients who completed two sessions and nine patients who completed three sessions were 3.15 and 3.51, respectively. Postinflammatory hyperpigmentation after treatment was only observed in 1 (1/16, 6.25%) patient. The 1064 nm picosecond Nd:YAG laser is an effective and safe approach for treating nevus of Ota.

Hematoporphyrin monomethyl ether photodynamic therapy for the treatment of facial port-wine stains resistant to pulsed dye laser.

BACKGROUND: Pulsed dye laser is the first treatment choice for port-wine stains. However, as some facial port-wine stains are resistant to this modality, we evaluated the efficacy and safety of hematoporphyrin monomethyl ether (hemoporfin) photodynamic therapy for the treatment of such resistant port-wine stains. METHODS: Patients were treated with two sessions of hemoporfin photodynamic therapy in our department. Patients received an intravenous injection of hematoporphyrin monomethyl ether (5 mg/kg) followed by 532 nm LED green light therapy. Three physicians graded the improvement in the port-wine stain, using a 4-level scale. Patients' satisfaction, reaction to treatment, and adverse effects were evaluated. RESULTS: Thirty-one patients (mean age, 23.9 ± 11.9 years, range, 3-48 years) were enrolled in this study. Hypertrophic lesions accounted for 48.4% of port-wine stain, with 80.6% of lesions being larger than 40 cm2. With regard to location, 41.9% were located on the central face and 32.3% involved a mix of the central and peripheral face. After one session, a treatment response was identified in 87.1% of cases, with the response deemed 'significant' in 29.0%. After two sessions, these rates increased to 100.0% and 61.3%, respectively. The clinical effect after two sessions was significantly greater than that after one session. Treatment reactions and adverse effects were well tolerated, and included pruritus, burning sensation, pain, edema, purpura-like change, blister, crust, and hyperpigmentation. CONCLUSIONS: Hemoporfin photodynamic therapy is a promising treatment for port-wine stains resistant to pulsed dye laser therapy.

Comparison of a picosecond alexandrite laser versus a Q-switched alexandrite laser for the treatment of nevus of Ota: A randomized, split-lesion, controlled trial.

BACKGROUND: Novel picosecond lasers have been available for various pigmentary disorders. However, there are limited data directly comparing picosecond lasers and Q-switched lasers for treatment of nevus of Ota. OBJECTIVE: To compare the efficacy and safety of a picosecond alexandrite laser (PSAL) with a Q-switched alexandrite laser (QSAL) for the treatment of nevus of Ota. METHODS: Each lesion of 56 enrolled participants was split into 2 parts and randomly assigned to either the PSAL or QSAL treatment arm. Each lesion was treated in up to 6 sessions in 12-week intervals. Efficacy and safety were determined using blinded visual evaluation and self-report at each follow-up visit. RESULTS: The PSAL arm achieved a significantly better clearance (5-point scale, PSAL 4.53 vs QSAL 4.0) with fewer sessions (PSAL 5.26 vs QSAL 5.87) and less severe pain (Visual Analog Scale, PSAL 5.61 vs QSAL 6.40). Patients were more satisfied with PSAL than QSAL (Likert scale, 4.5 vs 4.0). Occurrences of postinflammatory hyperpigmentation (PSAL 26% vs QSAL 34%) and hypopigmentation (PSAL 21% vs QSAL 47%) were also lower in PSAL than QSAL arm. LIMITATIONS: Lack of objective assessments and outcome measures. CONCLUSION: PSAL demonstrated better clinical results and fewer adverse events than QSAL for the treatment of nevus of Ota.

Q-switched Nd:YAG laser treatment for labial lentigines associated with Peutz-Jeghers syndrome.

BACKGROUND AND OBJECTIVE: Labial lentigines associated with Peutz-Jeghers syndrome are cosmetically disfiguring and distressful. Although multiple treatment modalities including Q-switched ruby laser and Q-switched alexandrite laser have been proposed, experience with Q-switched Nd:YAG laser has been lacking. This study aimed to retrospectively evaluate the efficacy and safety of Q-switched Nd:YAG laser (532 nm) for labial lentigines in Peutz-Jeghers syndrome. PATIENTS AND METHODS: Demographic and clinical data of 11 patients diagnosed with Peutz-Jeghers syndrome were analyzed. A quartile grading system was used. All patients were treated with a Q-switched Nd:YAG laser system with the following parameters: wavelength 532 nm; spot size 3 mm; pulse duration 5-20 ns; fluence 1.8-2.2 J/cm(2) . RESULTS: After two to six (mean 3.6) treatment sessions, an average grade of 3.73 was achieved. Eight patients (72.7 %) showed an excellent response with more than 75 % lesion clearance. Three patients (27.3 %) showed a good response. Repeated treatments led to improved clearance of labial lentigines. Age, gender, and Fitzpatrick skin type were not statistically associated with efficacy grades after the first treatment session. Neither recurrence in treated areas nor significant complications were observed. CONCLUSIONS: Q-switched Nd:YAG laser provides an effective and safe treatment option for labial lentigines associated with Peutz-Jeghers syndrome.

Comparison of a single treatment with Q-switched ruby laser and Q-switched Nd:YAG laser in removing black-blue Chinese tattoos.

BACKGROUND: Black and blue are two popular colors in Chinese tattooing. Two Q-switched lasers, ruby and Nd:YAG, are effective for tattoo removal. No reference with regard to a comparison of the effects and adverse reactions in Chinese individuals has been made in the literature. OBJECTIVE: To compare a single treatment of black-blue tattoos with the Q-switched ruby laser and Q-switched Nd:YAG (1064 nm) laser. METHODS: A total of 35 Chinese patients with black-blue tattoos at the laser center of the Institute of Dermatology, Chinese Academy of Medical Sciences were enrolled into a self-control study. Tattoos were split into two parts or two nearby tattoos on the same body part were used; one side was treated with the Q-switched ruby laser and the other with the Q-switched Nd:YAG laser. Immediate response, treatment outcome and adverse effects were compared. The statistical significance level was set at p< 0.05. RESULTS: Edema and exudation were more common immediately after ruby laser treatment (p< 0.05). The Q-switched Nd:YAG laser had a significant difference in tattoo lightening versus the Q-switched ruby laser after a single treatment (p<0.05). There was no significant difference in adverse effects between the two lasers. CONCLUSION: The Q-switched Nd:YAG laser is more effective at tattoo lightening for Chinese individuals. Its immediate response after treatment is slighter than the Q-switched ruby laser.