Treatment of small congenital nevocellular naevi using a combination of ultrapulse carbon dioxide laser and Q-switched frequency-doubled Nd-YAG laser.

This report describes treatment combining Ultrapulse CO(2) laser and Q-switched frequency-doubled neodymium:yttrium-aluminum-garnet (Nd-YAG) laser for a number of congenital nevocellular naevi (CNN). The Ultrapulse CO(2) laser removes the superficial component, which contains most of the color, preserving the integrity of the reticular dermis. At a later stage, any residual color is targeted using the Nd-YAG laser. To date, a total of 10 histologically proven CNNs have been treated at the Laser Suite. The median age of the patients was 18 years (range, 13-24 years). All the patients were white females. The patients accepted for treatment had relatively small lesions (mean surface area, 352 mm(2); range, 50-1,092 mm(2)), but the lesions were either cosmetically sensitive or located in an anatomically critical area in which excision could result in a scar that would be unpredictable. The median follow-up period was 24 months. The overall results have been satisfactory, with reduction of color and no significant scarring. The minor textural and pigmentary changes were acceptable to the patients.

Treatment of arborising telangiectasia with pulsed tunable dye laser (SPTL-1b).

Arborising telangiectasia is a rare but distinct progressive condition of unknown aetiology. The vessels are subepidermal and measure less than 0.2 mm in diameter. Twenty-three patients with this condition, involving the lower limbs and in extensive cases the upper limbs and trunk, have been treated with the flash lamp pulsed tunable dye laser (SPTL-1b, Candela Laser Corp.). Retrospective review of 17 of these patients, who have finished their treatment (average five sessions of therapy per patient, given at 3-4 monthly intervals), shows complete clearance of the telangiectasia in all cases. The mean follow-up time after the last session of treatment was 7 months. Temporary hyperpigmentation was seen in eight patients. Persistent pigmentary changes (one hyper- and one hypopigmentation) were noted in two patients. No evidence of scarring or change in skin texture was encountered. No progression or recurrence of telangiectasia was noted during the period of follow-up.

A role for lasers in the treatment of pigmented skin grafts.

The development of aberrant pigmentation represents an unwelcome complication to an otherwise successful split skin graft resulting in a loss of colour match and, so it follows, of cosmesis. We present two cases where lasers have been successful in the treatment of this problem.