Genital angiokeratomas of Fordyce 595-nm variable-pulse pulsed dye laser treatment

Background: Angiokeratoma of Fordyce (AF) represents dark red or blue-black papules with a scaly surface located on scrotum, labia majora, and penis. Though usually asymptomatic, bleeding after mechanical trauma and sexual intercourse may occur. AF should be differentiated from malignant melanoma, angiosarcoma, and other pigmented lesions. The treatment, usually asked from patients as the result of anxiety and social embarrassment, should be performed in a non-aggressive manner. Objectives: To determine the safety and effectiveness of 595-nm variable-pulse pulsed dye laser (VPPDL) with a Dynamic Cooling Device (DCD) in the treatment of AF. Methods: Twenty-four patients (22 men and two women) aged 40.88 ± 12.48 years with AF were included in the retrospective study. Lesions located on scrotum, labia majora, and penis were treated with 595-nm VPPDL in the intervals of one to three months. Variable spot, fluence, and pulse-width parameters were used with and/or without DCD skin cooling. Results: AF were successfully removed in all patients in one to seven (mean ± SD = 3.38 ± 2.16) treatment sessions with no permanent side effects or complications such as dyspigmentations or scarring. Recidives were observed in four patients after 0.5–1 year intervals. Conclusions: 595-nm VPPDL with DCD represents an efficient and safe method for the removal of multiple lesions of AF in genital localization.