Long-term follow-up in treatment of solar lentigo and café-au-lait macules with Q-switched ruby laser.

A Q-switched ruby laser was used for treatment of 10 patients with solar lentigo and 12 patients with café-au-lait macules. In this study, the lesions were treated with the laser at a rate of 6 J/cm2. The patients were observed for 10-21 months with an average of 13.8 months after the final session. Solar lentigos were treated once or twice, and the response rate was 70%. Café-au-lait macules were treated one to six times, and the response rate was 33%. Side effects, such as hyperpigmentation and scar formation, were rarely seen. Therefore, Q-switched ruby laser treatment is an effective treatment for epidermal pigmented lesions; however, in patients with café-au-lait macules, the responses to the treatment varied, and a repigmentation was seen in 50% of these patients. Thus, long-term follow-up is required for patients with café-au-lait macules.

Treatment of nevus of Ota by Q-switched ruby laser.

The effectiveness of the Q-switched ruby laser was investigated in 38 patients with nevus of Ota at more than 10 months after the first irradiation. In 14 patients who were followed-up for a mean of 25.2 months after the first treatment, the effectiveness was evaluated as "excellent" in eight patients (57%), "good" in four patients (28%), and "fair" in two patients (14%). The mean number of irradiation treatments was 7.3 in the "excellent" group, 4.2 in the "good" group, and 3.0 in the "fair" group. In 24 patients who were followed-up for a mean of 13.6 months after the first treatment, the effectiveness was evaluated as "excellent" in eight patients (33%), "good" in 12 patients (50%), and "fair" in four patients (16%). The mean number of irradiation treatment was 5.7 in the "excellent" group, 5.2 in the "good" group, and 2.5 in the "fair" group. Even after repetitive irradiations, good results without scarring were noted in all cases except one where a slight inverted scar was developed. The effective rate tended to be higher in patients who underwent more irradiation treatments and were observed for a longer period of time. Satisfactory cosmetic results were achieved after Q-switched ruby laser therapy for nevus of Ota.

Ruby laser treatment of pigmented skin lesions.

Pigmented skin lesions were treated by a ruby laser with a wavelength of 694 nm and a pulse duration of 450 microseconds. The clinical result of laser treatment was good in 18 of the 55 cases (32%). Five of 21 cases (23.8%) with cafe-au-lait maculae, 9 of the 14 cases (64%) with senile pigmentation, and 3 of the 10 cases (30%) with nevocellular nevus had good results. The cafe-au-lait maculae showed excellent fading after laser treatment but the recurrence rate was high. The best therapeutic result was obtained in senile pigmentation.

Polyotia. A case report.

An extremely rare case of polyotia is presented. A seven-month old male had a congenital deformity of the right auricle, appearing like a large accessory auricular appendage. It had a small helix-like protuberance connecting to a very long helical crus; there was a conchal cavity between the external auditory meatus and the protuberance. Surgery led to good results. The surgical procedure is described and the literature concerning polyotia discussed. Our diagnostic criteria for polyotia and the accessory auricular appendage are presented.

Hemangioma of the fingers.

Fingers often suffer trauma and the clinician is continuously faced with the difficult task of clarifying the distinction between a hemangioma and a traumatic lesion. This study was undertaken to examine ten cases in which a small skin mass located on a finger had been diagnosed preoperatively as hemangioma. Our results showed that seven masses were confirmed pathologically as hemangioma (five cavernous hemangiomas and two capillary hemangiomas), two as traumatic thrombosis and one varix. The clinical manifestations of the two cases of traumatic thrombosis were related to those of hemangioma. In the varix, endothelial proliferation was observed in the area of the thrombosis. This phenomenon is called "intravascular papillary endothelial hyperplasia", and can confuse the differential diagnosis between a vascular neoplasm and a traumatic thrombosis. Our findings demonstrate that since the traumatic lesions were firmer than the hemangiomas, hardness on physical examination may be a helpful indicator in the differential diagnosis of a hemangioma and a traumatic lesion.