Treatment of xanthelasma palpebrarum by 1064-nm Q-switched Nd:YAG laser: a study of 11 cases

BACKGROUND: Xanthelasma palpebrarum (xanthelasma) is a common disease involving the eyelids. It consists of yellowish plaques of esterified cholesterol situated in the middle and superficial layers of the dermis. Many techniques, including laser treatments, have been proposed to destroy these lesions. A preliminary study demonstrated the efficacy of 1064-nm Q-switched Nd:YAG laser in treating xanthelasma. OBJECTIVES: To present the results of a prospective study using 1064-nm Q-switched Nd:YAG laser to treat xanthelasma. METHODS: Thirty-eight lesions in 11 patients were treated. RESULTS: The results observed after a single treatment by Q-switched Nd:YAG laser were scored as good or excellent in eight patients, i.e. for 26 of 38 lesions. CONCLUSIONS: The treatment of xanthelasma by 1064-nm Q-switched Nd:YAG laser is a valuable treatment option to eliminate lesions, with rapid and good quality healing. The absence of any associated skin destruction allows treatment to be repeated when necessary.     

Q开关1064 nm Nd:YAG激光治疗黄褐斑所致点状色素减退:2年随访研究

目的:了解大光斑低能量模式Q开关1064 nm激光治疗黄褐斑后所致点状色素减退恢复情况。方法:对大光斑低能量模式Q开关1064 nm Nd:YAG激光治疗5次以上的180例黄褐斑患者随访2年。结果:15例出现点状色素减退(8.33%),2年后1例痊愈,2例有改善,13例无变化。结论:大光斑低能量Q开关1064 nm激光治疗黄褐斑所致的点状色素减退斑可持续2年以上。     

Comparison of the 532-nm KTP and 1064-nm Nd:YAG lasers for the treatment of cherry angiomas

Abstract

Background: Laser therapy is the treatment of choice for cherry angiomas since it is more effective and has better cosmetic results. There is no comparative study about the treatment efficacies with KTP and Nd:YAG lasers for cherry angiomas. Objective: To compare the efficacy and side effects of 532-nm KTP and 1064-nm Nd:YAG lasers for the treatment of cherry angiomas. Methods: Two comparable lesions of the same patient were chosen. One of them was treated with the KTP laser while the other was treated with the Nd:YAG laser. Sessions were repeated every 4 weeks until complete clearance was achieved. Side effects were evaluated using a severity scale (0 to 4). Results: The number of sessions was significantly higher with the KTP than with the Nd:YAG laser (p = 0.002). Erythema, edema, pain and scar formation were higher in the Nd:YAG laser group (erythema: p = 0.001; edema: p < 0.001; pain: p < 0.001; scar: p < 0.001). The hyperpigmentation rate was statistically higher with the KTP laser (p = 0.01). Conclusion: Both KTP and Nd:YAG lasers were found to be effective methods. The Nd:YAG laser offered fewer treatment sessions, but a higher risk of scar formation. The KTP laser seems more advantageous, but in dark-skinned patients the Nd:YAG laser may be preferable.     

Nd:YAG Q-switched laser for the treatment of a hemicorporal epidermal nevus: A safe and effective option

Epidermal nevi are benign proliferations of the epidermis for which different treatments have been used with disappointing results due to their recurrences and anesthetic scars. Topical therapies have generally been ineffective and surgical treatment provides more definitive results, but with high risk of scarring. In recent years, multiple laser modalities have been described for the treatment of these lesions. In the literature, there are no reported cases of treatment of these lesions with Neodymium-doped Yttrium aluminum garnet (Nd:YAG) laser. We present the case of a 3-year-old patient with a hemicorporal epidermal nevus treated with Nd:YAG laser at an early stage with good results.     

Photorejuvenation using long-pulsed alexandrite and long-pulsed neodymium:yttrium-aluminum-garnet lasers: a pilot study of clinical outcome and patients' satisfaction in Koreans

Long-pulsed 755-nm alexandrite and long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) lasers have been used for photorejuvenation of the face. The aim of this study was to investigate the safety and efficacy of long-pulsed alexandrite and long-pulsed Nd:YAG lasers for photorejuvenation in Korea. One hundred and sixteen Korean patients with photo-aged facial skin were enrolled. Sixty-two patients with facial pigmentation underwent long-pulsed alexandrite laser treatment. Eleven patients that wanted to improve facial pigmentation with minimal pain had quasi-long-pulsed alexandrite laser treatment. Forty three patients had long-pulsed Nd:YAG laser therapy. Outcome assessments included standard photographs and global evaluation by blinded investigators. The self-assessment grade was provided in questionnaires. Forty-four percent of patients reported excellent or good improvement of their pigmentary lesions (>50% improvement) using a long-pulsed alexandrite laser. Of patients who underwent long-pulsed Nd:YAG laser treatment, 36% reported excellent or good improvement in skin tightening, 50% in facial flushing and 45% in pigmentary lesions. We conclude that long-pulsed alexandrite and long-pulsed Nd:YAG lasers are safe and effective for facial photorejuvenation in Koreans.     

Variable pulse frequency-doubled Nd:YAG laser versus flashlamp-pumped pulsed dye laser in the treatment of port wine stains

The flashlamp-pumped pulsed dye laser (FPDL) is regarded as the gold standard in the treatment of port wine stains. The purpose of this prospective, intra-individual, comparative clinical study was to investigate whether a frequency-doubled variable pulsed Nd:YAG laser (frequency-doubled Nd:YAG) is equally as safe and effective as established lasers. Forty-three patients with port wine stains were included in the study. Test treatments were performed using the frequency-doubled Nd:YAG laser (532 nm; 4 mm psi; 5-50 ms; 5.5 to 15 J/cm2) versus the FPDL (585 nm; 450 micros; 7 mm psi; 6 J/cm2). After 6 weeks, a full lesional treatment was performed using the device and the parameters showing the best clearance and the fewest side effects. The clearance of the lesions was generally good to fair. With the exception of poor results at 5 ms and 5.5 J/cm2 with the frequency-doubled Nd:YAG laser, there were no significant differences between the two laser devices. Scar formation, nevertheless, occurred in only 3% of the FPDL-treated sites versus up to 18% of the frequency-doubled Nd:YAG sites, increasing with pulse duration. In port wine stains, the FPDL remains the therapy of choice because of the somewhat better results and a lower frequency of side effects, especially scarring.     

Nd: YAG laser (1,064 nm) fails to improve localized plaque type psoriasis: a clinical and immunohistochemical pilot study

Chronic and localized plaque-type-psoriasis is often therapy resistant as a result of which dermatologists often have trouble finding a suitable treatment option. Traditional therapies for psoriasis merely focus on the inhibition of epidermal proliferation, inflammation, or both. The earliest changes, however, in a novel psoriatic lesion concern abnormal microvasculature. The position of lasers in the treatment of psoriatic lesions is debatable, as different views exist with respect to efficacy and tolerability. The current investigation evaluates the clinical and immunohistochemical effect of the Nd:YAG (1,064 nm) laser in chronic localized psoriasis, as this laser can penetrate up to the deeper abnormal psoriatic vasculature. The effects are compared to treatment with the well-established calcipotriol/betamethasone dipropionate ointment. The use of the Nd:YAG laser with treatment-intervals of four weeks was found not to be of additional value in the array of treatment modalities for chronic localized plaque-psoriasis. Targeting the more superficially located microvasculature in psoriasis seems of stronger significance for achieving a clinical effect than the deeper vasculature targeted by the Nd:YAG laser. Therefore, the present data are of importance in preserving dermatologists from treating psoriatic lesions with a Nd:YAG laser. However, further studies incorporating changes in methodology, in particular shortened time-intervals between treatments, are needed in order to refute or confirm this position.     

A comparison of 3 lasers and liquid nitrogen in the treatment of solar lentigines: a randomized, controlled, comparative trial

OBJECTIVE: To determine if laser therapy is superior to liquid nitrogen for the treatment of solar lentigines and if so, to determine if one laser is superior to the other lasers that were tested. DESIGN: Randomized, controlled, comparative study with blinded observers. SETTING: University-based dermatology clinic. PARTICIPANTS: Twenty-seven patients with multiple solar lentigines on the backs of both hands. INTERVENTIONS: Liquid nitrogen cryotherapy, the Medlite II frequency-doubled Q-switched Nd:YAG laser (Continuum Biomedical, Livermore, Calif), the HGM K1 krypton laser (HGM Medical Laser Systems Inc, Salt Lake City, Utah), and the DioLite 532-nm diode-pumped vanadate laser (Iridex Corp, Mountain View, Calif). MAIN OUTCOME MEASURES: Photographs of the hands were taken prior to and 6 and 12 weeks following treatment. Blinded observers and patients evaluated each treatment on its ability to lighten pigmented lesions without causing unwanted adverse effects. RESULTS: Many new laser systems claim an advantage for treating pigmented lesions by selectively destroying melanin. In this study, the frequency-doubled Q-switched Nd:YAG laser was most likely to provide significant lightening (P<.05), followed by the HGM K1 krypton laser, the 532-nm diode-pumped vanadate laser, and liquid nitrogen. The frequency-doubled Q-switched Nd:YAG laser also had the fewest adverse effects (P<.05), while the HGM K1 krypton laser had the most (P<.05). Of the 27 patients, 25 preferred laser therapy to cryotherapy, with the frequency-doubled Q-switched Nd:YAG laser being the most popular. CONCLUSIONS: Laser therapy is superior to liquid nitrogen for the treatment of solar lentigines. Of the laser systems tested in this study, the frequency-doubled Q-switched Nd:YAG laser is the most effective.     

A case of solitary angiokeratoma successfully treated with a 1064-nm long-pulsed Nd:YAG laser

Angiokeratomas are vascular malformations that are clinically or histologically verrucous, with superficial vessels just beneath the epidermis. Solitary angiokeratomas occur most commonly as a small, warty, black papule on the lower extremities. Various therapeutic methods, including laser, electrocoagulation, excision, and cryotherapy, may be used for their treatment. A 13-year-old girl presented to the laser clinic for the treatment of her lesions that were present for two months. A 1064-nm long-pulsed Nd:YAG (yttrium aluminium garnet) laser was used to treat the patient's lesions. We performed two laser treatment sessions at a 4-week interval. We saw the patient 1 month after the last treatment session and obtained successful cosmetically acceptable results. No recurrence was observed over a follow-up period of 3 months. Long-pulsed Nd:YAG laser is more effective for the treatment of hyperkeratotic angiokeratomas due to deeper skin penetration of laser. Long-pulsed Nd:YAG laser is an effective and safe therapeutic option for the treatment of solitary angiokeratomas.     

Report of two angiokeratoma of Fordyce cases treated with a 1064 nm long-pulsed Nd:YAG laser

Various laser treatment modalities for angiokeratomas have been reported in the literature. A 60-year-old male patient presented for the treatment of multiple angiokeratomas of the scrotum and a 56-year-old female patient presented for the treatment of vulvar angiokeratomas. A 1064 nm long-pulsed Nd:YAG laser was used to treat the patients' lesions. The patients received two laser treatment sessions at an interval of 2 months. Nd:YAG laser treatment yielded successful results in the treatment of our patients' scrotal and vulvar angiokeratomas following two application sessions. We suggest that a long-pulsed Nd:YAG laser is a safe and effective method for the treatment of angiokeratoma of Fordyce.     

A split-face,evaluator-blind randomized study on the early effects of Q-switched Nd:YAG laser versus Er:YAG micropeel in light solar lentigines in Asians

Abstract

Background: Asians are prone to develop epidermal pigmentary lesions as a result of photoaging. Solar lentigines, especially those which are light in color, show somewhat limited response to pigment lasers and intense pulsed light sources. Objectives: We sought to compare the early effects as well as side effects of Q-switched Nd:YAG and Er:YAG micropeel in treating light solar lentigines in Asians. Patient and methods: This was a split-face, evaluator-blind, randomized controlled study. A single session of treatment was performed on Asian patients with light facial lentigines. Q-switched Nd:YAG laser was allocated to one half of the face, and Er:YAG micropeel to the other half. The response to therapy was evaluated by two independent dermatologists with standardized photographs taken 2 weeks and 1 month after the laser treatment. Patients’ satisfaction and preference in treatment were also assessed. Results: Fifteen patients completed the study and were analyzed. A reduction in pigment was observed with both lasers during the study period. The degree of pigment reduction in the Q-switched Nd:YAG treated side of the face was significantly higher than that of the Er:YAG micropeel treated side at 2-week follow-up (p < 0.001). The degree of pigment reduction between the Q-switched Nd:YAG-treated side and the Er:YAG micropeel-treated side was similar at 1-month follow-up (p = 0.110). Conclusion: While there is no perfect therapy for light solar lentigines, a single session of Q-switched Nd:YAG laser and Er:YAG micropeel was shown to reduce pigmentation. The immediate effects (2-week follow-up) were better with the Q-switched Nd:YAG laser but there was no great difference between the two laser types at 1-month follow-up due to the greater degree of post-inflammatory hyperpigmentation following Q-switched Nd:YAG. Both laser types could be applied either singly in turns, or in combination for maximal efficacy in future.     

Laser therapy of childhood haemangiomas

A total of 37 haemangiomas were treated in 28 patients by means of the flashlamp-pumped pulsed dye laser (FPDL). Twenty-nine haemangiomas were classified as superficial, and eight as mixed type. With FPDL treatment, excellent or good results were obtained in nearly 60% of superficial haemangiomas and 40% of mixed haemangiomas. In three of four patients with mixed type haemangiomas good results were obtained by means of Nd: YAG laser irradiation. In two patients, small superficial haemangiomas were removed by argon laser coagulation or CO² laser vaporization, respectively. These results indicate that many children benefit from laser therapy of haemangiomas. Side-effects were rare. The FPDL is the treatment modality of choice for superficial haemangiomas. and the Nd: YAG laser for thicker lesions. Based on our results and the results reported in the literature, early laser therapy of childhood haemangiomas can be recommended.     

Laugier-Hunziker syndrome: complete clearance of mucosal lentigines with a single session of Q-Switched Nd:YAG laser

Background: Laugier-Hunziker (LH) syndrome is a rare condition in which melanocyte overactivity produces lentiginous lesions of the lips and buccal mucosa. Objective: Given the paucity of reports on therapeutic options in LH syndrome, this case is herein reported to show the response to treatment with the Q-Switched Nd:YAG laser in a 32-year-old man with LH Syndrome. Methods: The Q-Switched Nd:YAG laser was used to treat the lentiginous lesions on the mucosal surface of the lower lips using a single pass at 532 nm. Results: There was complete clearance of the mucosal lentiginous lesions with a single laser session, and recurrence was not observed after 12 months. Conclusion: The Q-Switched Nd:YAG laser is an effective treatment option for cosmetic benefit in LH Syndrome.     

Laser surgical planning with magnetic resonance imaging-based 3-dimensional reconstructions for intralesional Nd:YAG laser therapy of a venous malformation of the neck

BACKGROUND: Three-dimensional (3-D) imaging using computed tomography or magnetic resonance imaging data is well known for surgical planning of complex lesions in neurosurgery. In dermatology, percutaneous and intralesional Nd:YAG laser therapy is well established for numerous types of vascular malformations. Diagnostic imaging using ultrasound, computed tomography, or magnetic resonance imaging is necessary to plan the laser therapy of those malformations. The therapeutic problem is to localize the venous malformation exactly before treatment on sectional 2-dimensional images. OBSERVATIONS: We describe a 27-year-old woman with a venous malformation of the neck. The data of diagnostic magnetic resonance imaging were used for a 3-D reconstruction of the venous malformation to demonstrate the anatomical extent and subcutaneous involvement for laser surgical planning. Percutaneous and intralesional laser therapy was performed at 3-month intervals with the Nd:YAG laser using the 3-D reconstruction as a road map for the Nd:YAG laser. Eight weeks after the last laser treatment, the bulky lesions of the neck showed regression. Using the 3-D reconstruction for laser surgical planning, physicians could perform intralesional laser treatment more exactly. The complex anatomy of the venous malformation could be elucidated by studying the 3-D images before and during laser surgery. CONCLUSION: The use of magnetic resonance imaging-based 3-D reconstructions for laser surgical planning can demonstrate the often unexpected extent and improve the intralesional laser therapy in the treatment of venous malformations.     

可变脉宽 Nd:YAG激光与强脉冲光治疗鲜红斑痣动物模型的研究

目的 通过动物模型研究可调脉宽Nd:YAG激光与强脉冲光对鲜红斑痣的治疗作用。方法 以38只莱亨鸡作为鲜红斑痣动物模型,随机分为4组,其中1组（2只）作为空白对照组不给予激光照射,其余3组（每组12只）分别给予可变脉宽Nd:YAG激光照射2次、强脉冲光照射2次、Nd:YAG激光和强脉冲光照射各1次,分别观察鸡冠形态学、组织学变化,对照射前后每高倍镜下血管数的变化进行统计学分析。结果 2次照射后,各组鸡冠被照射区颜色变淡,光镜下可见真皮血管层变薄,血管闭锁,血管数目减少。每高倍镜（ × 400）下血管数Nd：YAG照射组为（17.92 ± 3.63）个,强脉冲光照射组为（8.08 ± 1.56）个,联合照射组为（7.08 ± 1.31）个,与未照射的对照组（37.08 ± 3.97）个相比,各组血管数均减少,差异均有统计学意义（P < 0.01）。联合照射组与强脉冲光照射组比较,差异无统计学意义（P > 0.01）,但低于Nd:YAG组（P < 0.01）。结论 可变脉宽Nd:YAG激光照射、强脉冲光照射、两者联合照射均可用于鲜红斑痣的治疗。强脉冲光照射、二者联合照射治疗鲜红斑痣效果可能优于单独可变脉宽Nd:YAG激光照射。     

Q开关Nd:YAG激光治疗色素增加及血管增生等皮肤病的疗效分析

目的：观察Q开关Nd:YAG激光治疗色素增加及血管增生等皮肤病的临床疗效与治愈次数，以及影响疗效的有关因素。方法：用Q开关Nd:YAG激光（1064nm,532nm或585nm波长）治疗3977例色素啬及血管增生等皮肤病，观察，分析其疗效和美容效果。结果：Q形状d:YAG激光治疗色素增加及血管增生等皮肤病均有效，其中雀斑、美容文刺、文身和太田闱总有效率均达95％以上，痊愈率由高到低依次为：雀斑、美容文刺、面部色素恙、雀斑样痣、老年斑、文身、颧部褐青色痣、咖啡斑、外伤性文身、炎症后色素沉着、多毛症、太田痣、毛细血管扩张、蜘蛛痣、蓝痣、鲜红斑痣和毛表皮痣。治愈次数1－9次。结论：Q开关Nd:YAG激光治疗色素增加皮肤病的疗效及美容效果很好，而对多毛症和血管增生皮肤病疗效及美容效果相对较差。     

Comparison of pulsed dye laser versus combined pulsed dye laser and Nd:YAG laser in the treatment of inflammatory acne vulgaris

Background: Both pulsed dye laser and combined 585/1064-nm (sequential dual-wavelength PDL and Nd:YAG) laser improves inflammatory skin disorders including acne vulgaris. Objective: To compare the efficacy of 585-nm pulsed dye laser versus sequential dual-wavelength PDL and Nd:YAG in treatment of acne vulgaris. Patients and method: Thirty patients with acne vulgaris were treated by PDL alone on half of the face while contra lateral half was treated by combined 585/1064 nm laser. Results: The study showed that inflammatory acne lesions count was significantly reduced by 82.5% (p 0.0001) on PDL sides and by 83.5% (p 0.00001) on combined 585/1064-nm side after 8 weeks, while reduction of non-inflammatory acne lesions was observed at 8 weeks by 58.4% and 71.5% respectively. However, difference between the two modalities was not statistically significant. Conclusion: PDL and combined PDL/Nd:YAG laser treatment were found to be an effective, safe and well-tolerated treatment option for inflammatory and non-inflammatory acne vulgaris.     

大光斑低能量Q开关1064nm Nd:YAG激光治疗雀斑

目的:评价大光斑低能量模式Q开关1064 nm Nd:YAG激光治疗雀斑的疗效和安全性。方法:应用大光斑低能量模式Q开关1064 nm Nd:YAG激光治疗15例成人女性雀斑患者。治疗参数:波长1064 nm,脉宽10 ns,光斑7 mm,能量密度1.5~2.0 J/cm2,频率10 hz,每2~3周一次,治疗3~5次。末次治疗结束后随访6个月。结果:8例患者76%~100%皮损颜色变淡,4例51%~75%皮损颜色变淡,3例26%~50%皮损颜色变淡。所有患者治疗后仅有轻微红斑,数小时内消退,治疗后无色沉发生。随访6个月后2例患者复发。结论:大光斑低能量Q开关1064 nm Nd:YAG激光治疗雀斑安全有效。     

Láser Q-Swtiched Nd: YAG 1.064 nm para el tratamiento del nevus de Ota: resultados en 22 pacientes y revisión de la literatura

Introduction and Objective

Nevus of Ota (NO) is a facial cutaneous melanosis with a strong cosmetic impact. 1.064-nm Q-Switched (QS) neodymium-doped yttrium aluminum garnet (Nd:YAG) laser can selectively destroy melanocytes and melanosomas causing pigmentation and is an effective and well tolerated alternative in the treatment of NO. The objective of this study was to evaluate the effectiveness and adverse events of 1.064-nm Nd:YAG laser in the treatment of NO.

Patients and Methods

We performed a retrospective analysis of case files and photographic sessions of patients with benign pigmented lesions treated with 1.064-nm Nd:YAG laser between 2005 and 2010 in our center.

Results

Twenty-two patients with NO were found. 1.064-nm Nd:YAG laser, with a mean spot of 3 mm, a mean fluency of 5 J/cm² (range 4–10 J/cm²) and a frequency of 10 Hz was used. The mean number of sessions per patient was six (range 4 to 12 sessions). All patients had a clear rate of more than 50%, which was considered a favorable outcome. The only adverse event consisted of mild and transitory crusts.

Conclusions

This case-series confirms the results of previously published reports, showing the high efficacy of 1.064-nm Nd:YAG laser in the treatment of NO without severe adverse events. This treatment is cosmetically safe, with no evidence of long-term pigmentation or scarring. We believe the 1.064-nm QS Nd:YAG laser should be considered a first-line treatment in the management of NO.     

Laser therapy in cutaneous and genital warts: A review article

Traditional treatment modalities for wart require long‐term treatment course and usually have high recurrence rates and unwanted side effects. In this review article, we evaluated different types of laser therapy in the treatment of warts. Published articles since 2000 up to July 2020 about laser therapy in genital and non‐genital warts were searched and assessed. Fifty articles were selected for the final review, including 22 pulsed dye laser (PDL), 10 neodymium‐yttrium‐aluminum‐garnet (Nd: YAG), 3 erbium‐doped yttrium‐aluminum‐garnet (Er: YAG), 14 carbon dioxide (CO₂) laser and one systematic review. Complete response rates were different in terms of laser type used (0%‐100%, 9.1%‐100%, 83.3%‐100%, and 59.15%‐100% for PDL, Nd: YAG, Er: YAG, and CO₂ laser, respectively). There was no significant difference between conventional treatment modalities and laser therapy regarding efficacy and recurrence rate. Combination of lasers with keratolytic agents, immunomodulators and photodynamic therapy can be helpful especially in immunosuppressed patients, refractory, and recurrent lesions. PDL has the lowest occurrence of adverse effects relative to other types of lasers.