Treatment of Acquired Bilateral Nevus of Ota-Like Macules (Hori''s Nevus) with a Combination of the 532 nm Q-Switched Nd:YAG Laser Followed by the 1,064 nm Q-Switched Nd:YAG Is More Effective: Prospective Study

BACKGROUND: Acquired bilateral nevus of Ota-like macules (Hori's nevus) is a common dyschromatosis among Asian women. Q-switched lasers have been used successfully as a treatment modality. OBJECTIVE: The purpose of this study was to compare the efficacy of using the Q-switched 532 nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser followed by the 1,064 nm laser versus the Q-switched 1,064 nm Nd:YAG laser alone in the treatment of Hori's nevus. METHODS: This is a prospective left-right comparative study. Ten women with bilateral Hori's nevus were recruited and treated with a combination of the Q-switched 532 and 1,064 nm Nd:YAG lasers on the right cheek and the Q-switched 1,064 nm Nd:YAG laser alone on the left cheek. Only one laser treatment session was performed. The degree of pigmentation was objectively recorded with a mexameter. Subjective assessment was made by both patients and two blinded, nontreating dermatologists. RESULTS: At 6 months, there was a statistically significant difference (p = .009) of 35.10 points using objective mexameter measurements between the two sides, favoring the side treated with a combination of 532 and 1,064 nm laser treatment. Subjective grading by the patients and blinded dermatologists also confirmed that combination therapy was more successful after one treatment. Although combination treatment had a higher incidence of mild postinflammatory changes, this disappeared within 2 months. CONCLUSIONS: Concurrent use of the Q-switched 532 nm Nd:YAG laser in combination with the 1,064 nm laser is more effective in pigment clearance than the Q-switched 1,064 nm Nd:YAG laser alone for Hori's nevi.     

Treatment of nasal ala nodular congenital melanocytic naevus with carbon dioxide laser and Q-switched Nd:YAG laser

Total excision of congenital melanocytic nevi (CMN) is not always feasible. We here present our experience of using carbon dioxide laser and Q-switched neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser to treat nodular CMN of the nasal ala. Q-switched Nd:YAG laser and/or carbon dioxide laser were used to treat eight cases of nasal ala nodular CMN. Carbon dioxide laser was utilized to ablate all visible melanocytic tissue within one session. Ablation was performed so as to reproduce the original anatomical contours as closely as possible. Recurrences were treated in the same way. Q-switched Nd:YAG laser was also used to irradiate all target lesions to achieve the desired end point within one session. The intervals between treatments were at least 8 weeks. Recurrence of melanocytic tissue, scar formation, pigmentation, depigmentation, and the degree of patient satisfaction were recorded at every visit. Two of the eight patients were treated with Q-switched Nd:YAG laser. Although, the lesion lightened in one of them, the hyperplastic tissue persisted. Eventually, these two patients, along with the remaining six patients, were successfully treated with a carbon dioxide laser. We recommend carbon dioxide laser treatment for nodular nasal CMN. This simple treatment does not involve skin flap transplantation and has good cosmetic outcomes. Although Q-switched Nd:YAG laser does lighten some nasal nodular CMNs, it does not eradicate the hyperplastic tissue, and is therefore not an effective treatment for nodular nasal CMN.     

Q-switched Nd:YAG laser treatment for acquired bilateral nevus of ota-like maculae: a long-term follow-up

BACKGROUND AND OBJECTIVE: Acquired bilateral nevus of Ota-like maculae (ABNLM) is not an uncommon dermal melanosis in Asian people. It is known for its recalcitrance to conventional treatment. We proposed Q-switched Nd:YAG laser for the treatment of this entity. STUDY DESIGN/PATIENTS AND METHODS: Seventy female patients with ABNLM, who were 25-40 years old (mean, 37 years), were included in a prospective clinical study. Q-switched Nd:YAG laser at fluence of 8-10 J/cm(2), spot size 2 or 4 mm, and a repetition rate of 10 Hz was used to treat the lesions. RESULTS: Two patients were lost to follow-up. In the remaining 68 cases, all lesions attained a 100% clearance after two to five treatment sessions (mean, 2.8 sessions). The results had persisted at 3-4 years follow-up (mean, 42 months). Temporary hyperpigmentation was found in 50% of patients; there was no scarring or changing of skin texture. CONCLUSION: Q-switched Nd:YAG laser is a safe and effective noninvasive alternative treatment for ABNLM.     

In vivo trial comparing patients' tolerance of Q-switched Alexandrite (QS Alex) and Q-switched neodymium:yttrium-aluminum-garnet (QS Nd:YAG) lasers in the treatment of nevus of Ota

BACKGROUND AND OBJECTIVES: Different types of Q-switched lasers have been found to be effective in the treatment of nevus of Ota. However, a clinical trial involving in vivo comparison of the use of different laser systems has not been performed. The aim of the present study was to compare the patient tolerance of Q-switched Alexandrite (QS Alex) and Q-switched neodymium:yttrium-aluminum-garnet (QS Nd:YAG) lasers in the treatment of nevus of Ota. STUDY DESIGN/MATERIALS AND METHODS: Thirty-three patients (11 male, 22 female) were recruited for this study, and 45 treatment sessions were performed. Half of each lesion was treated with QS Alex and the other half with QS Nd:YAG laser. Patients were interviewed with a visual analog scale questionnaire immediately after treatment and 1 week later. Questions included the degree of pain, swelling, and bleeding. RESULTS: The immediate pain after treatment was more severe for QS Alex than for QS Nd:YAG laser. However, 1 week after laser therapy, most patients found QS Alex to be superior. CONCLUSION: Patients tolerate QS-Alex better than QS Nd:YAG. This finding is important because patients with nevus of Ota are often children, and multiple laser sessions are necessary for complete resolution of the lesion.     

Q开关Nd:YAG美肤激光治疗太田痣317例

目的:观察Q开关Nd:YAG激光系统治疗太田痣的疗效和安全性。方法:应用Q开关Nd:YAG激光仪对317例太田痣患者进行皮损区的多次照射治疗。治疗间隔时间2～3个月,根据皮损不同颜色、部位、年龄及治疗经验选择不同能量和光斑大小。结果:治疗次数与疗效成正比相关,治疗次数越多,效果越好。接受治疗≤5次时,儿童临床效果较成人好;远期疗效儿童组与成人组相同。结论:Q开关Nd:YAG激光治疗太田痣安全有效,预后好。     

An In Vivo Trial Comparing the Clinical Efficacy and Complications of Q-Switched 755 nm Alexandrite and Q-Switched 1064 nm Nd:YAG Lasers in the Treatment of Nevus of Ota

BACKGROUND: Q-switched 755 nm alexandrite (QS alex) and Q-switched 1064 nm Nd:YAG lasers are effective in the treatment of nevus of Ota. Our previous in vivo study indicated that patients better tolerate QS alex than QS 1064 nm Nd:YAG laser. However, in terms of clinical efficacy and long-term complications, the study did not indicate which laser is superior. Although both machines may appear to be similar in effectiveness, the low number of treatment sessions may contribute to this apparent lack of difference. OBJECTIVE: The aim of this study was to compare the clinical efficacy and complications of QS 755 nm alex and QS 1064 nm Nd:YAG lasers in the treatment of nevus of Ota after three or more treatment sessions. METHOD: Forty patients were recruited for this study and all had received three or more laser treatment sessions with an interval of at least 2 months between each. Half of the lesion was treated with QS alex and the other half with QS 1064 nm Nd:YAG laser. The degree of lightening was assessed subjectively by the patient using a visual analog scale and objectively by two independent clinicians. Patients were called back to be examined for evidence of complications. RESULTS: In terms of subjective degree of lightening, QS 1064 nm Nd:YAG laser was found to be significantly more efficacious than QS alex (P = 0.018). Both clinicians also found QS 1064 nm Nd:YAG laser to be more effective, but statistical significance was only detected in one, not both of their scores (P = 0.005 and 0.414 for observers 1 and 2, respectively). More patients that received QS Alex developed complications (4 for QS alex and 2 for QS Nd:YAG), but the difference was not statistically significant. CONCLUSION: QS 1064 nm Nd:YAG laser appears to be more effective than QS alex in the lightening of nevus of Ota after three or more laser treatment sessions. However, the majority (55%) of the patients reported no differences in results between the two lasers, and only one of the two observers noted statistically significant improvement of QS 1064 nm Nd:YAG over QS alex.     

Q开关Nd∶YAG激光两种治疗参数治疗颧部褐青色痣的疗效比较

目的：用Q开关Nd∶ YAG激光的两种不同治疗参数治疗颧部褐青色痣,比较两种治疗参数的疗效及安全性差异.方法：颧部褐青色痣患者52例,采用Q开关Nd∶ YAG激光的低能量大光斑参数（A组）治疗22例,常规高能量参数（B组）治疗30例,治疗后以色素斑片的面积大小、色度变化评价疗效.统计患者的疼痛度、停工期及并发症发生情况.结果：B组治疗后色素斑面积减少及色度减少较A组明显,疗程缩短,但停工期更长,且并发症比A组增多,两者差异具有统计学意义.结论：两种不同治疗参数均可用于治疗褐青色痣,用常规高能量参数治疗效果更为显著,但患者治疗时疼痛明显,术后停工期长,且有局部色素沉着;而低能量大光斑参数疼痛轻微,停工期较短,疗效相对稍差.     

A study on the clinical characteristics of treating nevus of Ota by Q-switched Nd:YAG laser

The purpose of this study was to retrospectively analyze the clinical characteristics of treating nevus of Ota by Q-switched Nd:YAG laser in Laser Cosmetology Center of Department of Dermatology, the Second Hospital, Xi’an Jiaotong University. The data of 1168 patients of nevus of Ota were analyzed retrospectively, which included the correlation among lesion color, treatment sessions, sex, age, lesion types, and effect. The Q-switched (QS) Nd:YAG laser system had a higher number of treatment sessions which were positively associated with a better response to treatment. Other variables, including gender, age, the categorization of the lesion according to Tanino’s classification, and the color of the lesion, were not associated with the response to treatment. The treatment of nevus of Ota with QS Nd:YAG laser is safe and effective, with rare complications.     

Q开关Nd:YAG激光联合强脉冲光治疗雀斑临床观察

目的:寻找临床上对雀斑的最佳治疗方法。方法:采用Q开关倍频Nd:YAG激光和强脉冲光联合治疗雀斑,进行疗效观察,并与继往单纯采用Q开关激光治疗的病例进行疗效对比研究。结果:单纯用Q开关激光治疗的224例雀斑患者,痊愈178例(79.5%),采用Q开关激光联合强脉冲光治疗的52例雀斑患者,痊愈50例(96.2%)。两组痊愈率之间差异有显著性。结论:采用激光与强脉冲光联合治疗雀斑疗效好、副作用小,值得临床推广。     

A Retrospective Analysis of Complications in the Treatment of Nevus of Ota with the Q-Switched Alexandrite and Q-Switched Nd:YAG Lasers

BACKGROUND: Studies on the use of Q-switched alexandrite (QS alex) and QS Nd:YAG lasers in the treatment of nevus of Ota were limited to case reports and small series. There was no study that looked at the complication rate of these systems. OBJECTIVE: To retrospectively study the complication rate of nevus of Ota patients that were treated with QS alex laser, QS Nd:YAG laser, or a combination of both. METHODS: The study was performed in a teaching hospital and a private hospital, where 513 patients with nevus of Ota had been treated since 1993. The 171 patients with 211 treatment sites were evaluated retrospectively following treatment with QS alex laser only (n = 58), QS Nd:YAG laser (n = 105) only, or a combination of both systems (n = 48). Patients were called back to be interviewed and examined by two independent clinicians to look for evidence of complications. RESULTS: Of the treatment sites, 15. 3% had hypopigmentation, 2.9% had hyperpigmentation, and texture changes and scarring were seen in 2.9% and 1.9%, respectively. The combined treatment group was associated with a significantly higher risk of complications. Thirteen patients had recurrence of their nevus after complete or near-complete clearance with laser treatment. CONCLUSION: Hypopigmentation is common after the use of QS laser for lightening of nevus of Ota. This particularly applies when alternate treatment with QS alex and QS Nd:YAG is used. Recurrence is an important issue and must be taken into consideration, especially when children are treated.     

Q开关激光治疗双侧面部获得性太田痣样斑287例疗效分析

目的：比较Q开关紫翠宝石755nm激光、Nd：YAG1064nm激光和倍频Nd：YAG532nm激光对双侧获得性太田痣样斑的治疗效果和副作用。方法：运用Q开关紫翠宝石755nm激光、Nd：YAG1064nm激光和倍频Nd：YAG532nm激光分别对287例患者进行治疗。结果：经过1～13次治疗后,痊愈140例,显效66例,有效59例,无效22例,总有效率71.8%,总治愈率48.8%。倍频Nd：YAG532nm激光治疗起效快而副反应明显,Q开关紫翠宝石755nm激光和Nd：YAG1064nm激光起效慢但副反应轻微。结论：三种Q开关激光均能有效治疗双侧获得性太田痣样斑,长程低能量的Q开关紫翠宝石755nm激光和Nd：YAG1064nm激光因副反应轻微更适合美容患者的需要。     

Treatment of Pigmented Hypertrophic Scars with the 585 nm Pulsed Dye Laser and the 532 nm Frequency-Doubled Nd:YAG Laser in the Q-Switched and Variable Pulse Modes: A Comparative Study

BACKGROUND: Pigmented hypertrophic scars are a difficult condition to treat. They may result from traumatic injuries or from surgical and cosmetic procedures. The 585 nm flashlamp-pumped pulsed dye laser (FLPDL) has been used to treat this condition, with significant improvement of varying degrees. It remains to be determined whether other laser modalities may have a similar or even greater success in the treatment of pigmented hypertrophic scars. OBJECTIVE: To determine the efficacy of the 532 nm frequency-doubled Nd:YAG laser in the treatment of pigmented hypertrophic scars as compared to the 585 nm FLPDL. METHODS: Six patients with pigmented hypertrophic scars and skin phototypes II-IV were chosen. A scar was selected for treatment in each patient and divided into four equal 2 cm segments. Three segments were each treated with a different laser modality and one was left untreated to serve as the control. A 585 nm FLPDL was used with an energy of 3.5 J, a pulse duration of 450 microsec, and a 10 mm spot size. A 532 nm Q-switched frequency-doubled Nd:YAG laser was set to an energy of 2.8 J, a 10-nsec pulse, and a 3 mm spot size. The same 532 nm laser was set to the variable pulse mode to treat a 2 cm scar segment, with an energy of 9.5 J, a 10-msec pulse, and a 4 mm spot size. An average of 3.3 treatments were performed on each scar segment, at intervals of 4-6 weeks and long-term follow-up at 22 weeks. Treatment outcome was graded by a blind observer using the Vancouver General Hospital (VGH) Burn Scar Assessment Scale. A SigmaStat t-test was used to determine the statistical significance of the values obtained. RESULTS: Treatment of pigmented hypertrophic scars with the 532 nm Q-switched Nd:YAG laser led to a significant improvement of 38% in the VGH scores when compared to baseline (P =.005). The 585 nm FLPDL also had a favorable effect on the scars, with an average improvement of 36.1% in the VGH scores. There was no significant difference noted between the outcome of treatment with either of these two lasers. Treatment with the 532 nm variable pulse Nd:YAG laser led to a 19% improvement in the VGH scores of scars, which did not differ significantly from the 16.1% improvement observed in control scars on the last follow-up visit. No side effects or complications from treatment were noted or reported during the course of the study. At the conclusion of the study, five of six patients chose the segment treated with the 532 nm Q-switched Nd:YAG laser as the best segment overall. CONCLUSION: The 532 nm Q-switched Nd:YAG laser and the 585 nm FLPDL offer comparable favorable results in the treatment of pigmented hypertrophic scars. The 532 nm Q-switched Nd:YAG laser may be preferred by patients particularly distressed by the dark color of their scars.     

非剥脱性Q开关Nd：YAG 1 064 nm激光对黄褐斑的治疗效果

目的 观察非剥脱性Q开关Nd：YAG 1 064 nm激光对黄褐斑的治疗效果.方法 应用Q开关Nd：YAG 1 064 nm激光对23例黄褐斑患者进行治疗,其光斑直径6 mm,脉宽5～7 ns,频率10 Hz,能量密度1.8～2.0 J/cm2.一般需8～10次治疗,每次治疗间隔1周.结果 23例经8～10次治疗后,黄褐斑明显淡化或消失,局部出现轻度充血,无水泡和结痂形成,基本治愈率达52.17%.5例出现眼睑紫癜,3 d后自行消退,无色素沉着及瘢痕发生.术后随访6个月以上,其中7例（占30.4%）出现复发,继续治疗仍然有效.结论 非剥脱性Q开关Nd：YAG 1 064 nm激光治疗黄褐斑虽有复发,仍不失为一种比较可行的治疗方法 ,有一定效果,操作简单、安全,不影响患者的工作和生活.     

非剥脱性Q开关Nd:YAG 1 064 nm激光对黄褐斑的治疗效果

目的 观察非剥脱性Q开关Nd:YAG 1 064 nm激光对黄褐斑的治疗效果.方法 应用Q开关Nd:YAG 1 064 nm激光对23例黄褐斑患者进行治疗,其光斑直径6 mm,脉宽5～7 ns,频率10 Hz,能量密度1.8～2.0 J/cm2.一般需8～10次治疗,每次治疗间隔1周.结果 23例经8～10次治疗后,黄褐斑明显淡化或消失,局部出现轻度充血,无水泡和结痂形成,基本治愈率达52.17%.5例出现眼睑紫癜,3 d后自行消退,无色素沉着及瘢痕发生.术后随访6个月以上,其中7例(占30.4%)出现复发,继续治疗仍然有效.结论 非剥脱性Q开关Nd:YAG 1 064 nm激光治疗黄褐斑虽有复发,仍不失为一种比较可行的治疗方法 ,有一定效果,操作简单、安全,不影响患者的工作和生活.     

非剥脱性Q开关Nd:YAG 1 064 nm激光对黄褐斑的治疗效果

目的 观察非剥脱性Q开关Nd:YAG 1 064 nm激光对黄褐斑的治疗效果.方法 应用Q开关Nd:YAG 1 064 nm激光对23例黄褐斑患者进行治疗,其光斑直径6 mm,脉宽5～7 ns,频率10 Hz,能量密度1.8～2.0 J/cm2.一般需8～10次治疗,每次治疗间隔1周.结果 23例经8～10次治疗后,黄褐斑明显淡化或消失,局部出现轻度充血,无水泡和结痂形成,基本治愈率达52.17%.5例出现眼睑紫癜,3 d后自行消退,无色素沉着及瘢痕发生.术后随访6个月以上,其中7例(占30.4%)出现复发,继续治疗仍然有效.结论 非剥脱性Q开关Nd:YAG 1 064 nm激光治疗黄褐斑虽有复发,仍不失为一种比较可行的治疗方法 ,有一定效果,操作简单、安全,不影响患者的工作和生活.     

调Q开关Nd:YAG激光治疗色素性皮肤病1051例临床观察

目的探讨调Q开关Nd∶YAG激光治疗色素性皮肤病的疗效和不良反应。方法回顾性分析调Q开关Nd∶YAG激光治疗1 051例色素性皮肤病的临床疗效和不良反应,其中太田痣365例、雀斑103例、咖啡斑106例、褐青色痣43例、雀斑样痣37例、文身128例、外伤性文身57例、斑痣96例、脂溢性角化116例。结果太田痣、雀斑、脂溢性角化疗效最好,总有效率均为100%,褐青色痣、文身和外伤性文身亦有上佳疗效,总有效率均在90%以上。咖啡斑、雀斑样痣、斑痣亦有不同程度疗效,总有效率分别为63.2%、51.4%、45.8%。结论调Q开关Nd∶YAG激光治疗色素性皮肤病安全性高,对绝大多数太田痣、雀斑、脂溢性角化、褐青色痣、文身、外伤性纹身可达到治愈的效果,对咖啡斑、雀斑样痣、斑痣亦有一定程度的疗效。     

调Q532nm激光联合2940nm点阵铒激光治疗斑痣64例疗效观察

目的:观察应用Q532nm激光联合Er:YAG 2 940nm激光治疗斑痣的疗效。方法:采用Q开关532nm激光,能量密度1.4~1.7J/cm2,光斑直径2~3mm,频率5.0~10Hz,治疗浅褐色片状斑。采用Er:YAG 2 940nm激光,SP模式,能量密度5.7~6.4J/cm2,光斑直径2~3mm,频率4~6Hz,治疗表面散在的深棕褐色斑疹。64例患者中,9例治疗1次,45例治疗2次,10例治疗3次,治疗间隔3个月,随访12个月。结果:64例患者,总有效率100%,其中痊愈19例,显效45例,无效0。无1例出现永久性色素沉着和继发性瘢痕。结论:Q开关532nm激光联合2 940nm点阵铒激光治疗斑痣是较为有效、安全的方法,临床效果令人满意,值得推广。     

Noninvasive Treatment of Bromidrosis by Frequency-Doubled Q-Switched Nd:YAG Laser

Axillary bromidrosis (osmidrosis) is a common and disgusting disorder in Asian communities. Current treatments are basically invasive resulting in varying degrees of success and complications. The objective of this study was to investigate the efficacy of frequency-doubled Q-switched Nd:YAG laser as a possible noninvasive technique for treating axillary bromidrosis. Sixty-four axillae of 32 patients were lased by a single session of green light energy at the fluence of 3.5 joules at a 4-mm spot size. The follow-up time was 6–18 months (mean 15). Twenty-six patients (81.2%) showed good to excellent results, 4 patients (12.5%) had fair results, and 2 (6.2%) patients had poor results. The only side effect was a temporary hyperpigmentation at the periphery of the treated area in a few patients with dark skin color. In conclusion, frequency-doubled Q-switched Nd:YAG laser is an effective noninvasive treatment for axillary bromidrosis.     

Combined laser therapy for difficult dermal pigmentation: resurfacing and selective photothermolysis.

Treating pigmented lesions of the skin, especially deep dermal pigmentations, are difficult to achieve satisfactory results without complications. To treat dermal pigmentations, such as nevus of Ota and congenital nevus, the combined therapy of a resurfacing laser (CO2) and a selective photothermolytic laser (the Q-Switched Ruby Laser [QSRL]) was tried, and the results were compared with those treated with the QSRL alone. Combined laser therapy has been performed in 47 patients with nevus of Ota since 1995. The mean treatment period was 6 months and the mean number of treatment was five. Of 47 patients, 46 (98%) showed excellent results. To treat congenital nevus, combined laser therapy was used in 15 patients, and 12 (80%) showed good to excellent results. By combining resurfacing and selective lasers, the treatment period has been reduced by 2 to 3 months, and the number of treatments has been reduced two- to threefold. Furthermore, treatment of congenital nevus has become possible, which was not the case with the QSRL alone. The Er:YAG laser can be used for resurfacing instead of the CO2 laser because it causes less thermal damage and faster wound healing.     

Histologic Evaluation of a Q-Switched Nd:YAG Laser in the Nonablative Treatment of Wrinkles

BACKGROUND: A variety of nonablative dermal remodeling techniques are currently available. The Q-switched Nd:YAG laser, in addition to its role in tattoo removal, hair removal, and vascular and pigmented lesion treatment, may also play a role in dermal remodeling for the treatment of wrinkles. The histologic changes seen in human skin after Q-switched Nd:YAG laser exposure have yet to be evaluated. OBJECTIVE: To study histologic changes after the use of a Q-switched Nd:YAG laser in the nonablative treatment of photoaged skin. METHODS: Sun-damaged infrauricular skin from six female subjects was exposed to a Q-switched Nd:YAG laser at fluences of 7 J/cm2 with two laser passes. Histologic examinations were performed before laser treatment and 3 months later. RESULTS: Biopsy specimens showed slight fibrosis in the superficial papillary dermis with unremarkable epidermal changes. CONCLUSION: The Q-switched Nd:YAG laser produced morphologic changes similar to, but lesser in degree, than those seen with both CO2 and Er:YAG laser resurfacing.