Depigmentation Therapy with Q-Switched Ruby Laser After Tanning in Vitiligo Universalis

BACKGROUND: In vitiligo universalis, repigmentation therapy is seldom effective. Besides, bleaching cream which is often used in depigmentation therapy may lead to several serious complications. OBJECTIVE: Q-switched (QS) ruby laser can destroy melanosomes in melanocytes and keratinocytes by selective photothermolysis. METHODS: We have attempted to destroy melanocytes by using the QS ruby laser after tanning in a patient with extensive vitiligo. RESULTS: The patient had excellent results with no evidence of repigmentation after 1 year. CONCLUSION: Depigmentation therapy with QS ruby laser after tanning is an effective and safe way of removing remnants of normal pigmentation in patients with vitiligo universalis.     

Minocycline-Induced Hyperpigmentation Treated with a 755-nm Q-Switched Alexandrite Laser

BACKGROUND: Cutaneous pigmentation associated with minocycline therapy is an unusual adverse effect for which few successful treatments have been described. The pigment changes may persist for years, despite cessation of therapy, and is often cosmetically disfiguring, causing significant embarrassment and psychological depression in those affected. Few safe and effective treatments have been described in the past; however, recent pigment-specific laser technology has shown promise in the treatment of this condition. OBJECTIVE: The objective was to describe a series of patients with minocycline-induced hyperpigmentation who were successfully treated with a 755-nm Q-switched alexandrite laser. METHODS: Six patients with minocycline-induced hyperpigmentation on the face or legs were treated with a Q-switched alexandrite laser on a bimonthly basis until pigmentation was eradicated. RESULTS: Cutaneous pigmentation resolved completely in all patients in an average of four laser sessions. Side effects were limited to transient purpura and mild desquamation without scarring or dyspigmentation. CONCLUSION: Minocycline-induced cutaneous pigmentation can be effectively cleared without risk of adverse sequelae by Q-switched alexandrite (755-nm) laser irradiation.     

Q-Switched Alexandrite Laser-induced Chrysiasis

Background: Chyriasis is an uncommon side effect that occurs in patients who are receiving prolonged treatment with either intravenous or intramuscular gold as a distinctive blue-gray pigmentation of light-exposed skin. Laser-induced chrysiasis is a rarely described phenomenon in individuals who have received systemic gold and are subsequently treated with a Q-switched laser. Purpose: To describe the characteristics of patients with laser-induced chrysiasis. Methods: The authors describe a 60-year-old woman who developed chrysiasis at Q-switched alexandrite laser treatment sites. They also reviewed the medical literature using PubMed, searching the terms chrysiasis, gold, and laser-induced. Patient reports and previous reviews of these subjects were critically assessed and the salient features are presented. Results: Including the authors’ patient, laser-induced chrysiasis has been described in five Caucasian arthritis patients (4 women and 1 man); most of the patients had received more than 8g of systemic gold therapy during a period of 3 to 13 years. Gold therapy was still occurring or had been discontinued as long as 26 years prior to laser treatment. All of the patients immediately developed blue macules at the Q-switched laser treatment site. Resolution of the dyschromia occurred in a 70-year-old woman after two treatment sessions with a long-pulsed ruby laser and the authors’ patient after a sequential series of laser sessions using a long-pulsed alexandrite laser, followed by a nonablative fractional laser and an ablative carbon dioxide laser. Conclusion: Laser-induced chrysiasis has been observed following treatment with Q-switched lasers in patients who are receiving or have previously been treated with systemic gold. It can occur decades after treatment with gold has been discontinued. Therefore, inquiry regarding a prior history of treatment with gold—particularly in older patients with arthritis—should be considered prior to treatment with a Q-switched laser. Also, treatment with a long-pulsed laser should be entertained in patients with either idiopathic or laser-induced chrysiasis. (JClinAesthetDermatol. 2015;8(9):48-53.)Chrysiasis is a distinctive blue-gray pigmentation of light exposed skin occurring in individuals who are receiving parenteral gold therapy.1 The 755nm Q-switched alexandrite laser is effective for the treatment of facial lentigines since the melanin granules absorb a high proportion of the laser energy and other chromophores offer little competitive absorption.2 The authors describe a woman who developed chrysiasis at Q-switched alexandrite laser treatment sites and whose dyschromia was successfully treated with a sequential series of laser sessions using a long-pulsed alexandrite laser, followed by a nonablative fractional laser and an ablative carbon dioxide laser.     

Depigmentation with Q-switched Nd:YAG laser in universal vitiligo: a long-term follow-up study of 4 years

Q-switched (QS) lasers are used for depigmentation in universal vitiligo, but there is limited data on long-term results after laser treatment. This study was conducted to assess the safety and long-term follow-up results of QS Nd:YAG laser treatment in combination with need-based topical depigmentation therapy for universal vitiligo. A retrospective study was performed on patients with universal vitiligo who had received QS Nd:YAG laser treatment from 2010 to 2013. All patients were contacted and called for follow-up. Patients who reported were assessed clinically and information regarding adverse effects and relapse (repigmentation) in the follow-up period were obtained. Any need for topical depigmenting creams or other interventions and overall satisfaction to treatment were also documented. Records of 34 patients were retrieved, out of whom 28 cases reported for the follow-up visit. Duration of follow-up ranged from 2 to 5 years (mean, 2.78). No long-term adverse effects were reported and the majority of patients were highly satisfied with treatment. Satisfactory results with >90% clearance of pigment was reported by 89.3% (25/28) of patients, out of whom 72% (18/25) had retained the therapeutic effect with the use of sunscreens with/without intermittent topical depigmentation therapies. In seven cases, partial to complete relapse was observed. QS Nd:YAG laser is an effective tool for treating residual pigmentation in universal vitiligo, and the therapeutic effect can be maintained in most cases with regular sunscreen use and need-based topical therapies.     

Q开关紫翠宝石激光治疗Peutz-Jeghers综合征色素沉着的疗效分析

目的:观察Q开关紫翠宝石激光治疗Peutz-Jeghers综合征色素沉着的临床疗效及不良反应。方法:采用Q开关紫翠宝石激光对18例Peutz-Jeghers综合征患者的色素沉着进行治疗,治疗次数1～3次,每次治疗间隔3～6个月,根据治疗前后的照片对比判定疗效。结果:18例患者,11例痊愈(占61.1%),6例显效(占33.3%),1例有效(占5.6%),总有效率达94.4%,无瘢痕等严重不良反应。结论:Q开关紫翠宝石激光治疗Peutz-Jeghers综合征临床疗效佳,不良反应少。     

Q-开关翠绿宝石激光治疗常见色素增加性皮肤病临床疗效观察

目的：探讨Q-开关翠绿宝石激光治疗常见色素增加性皮肤病的疗效及安全性。方法：应用AlexLazr Q-开关翠绿宝石激光不同剂量针对360例面部色素增加性皮肤病患者进行治疗,并随访3～6个月,观察治疗后效果及预后。结果：总有效率为98.6%,术后出现局部紫癜、疼痛、暂时性色素沉着、水疱等,无色素减退和瘢痕出现。结论：Q-开关翠绿宝石激光治疗常见色素增加性皮肤病安全、有效。     

A case of labial lentigines in Peutz-Jeghers syndrome treated using a Q-switched alexandrite laser

Peutz-Jeghers syndrome (PJS) is a polygenic autosomal dominant disease characterized by multiple gastrointestinal polyps and pigmentation of the mucosa and skin. While there are a few reports regarding successful treatment of intestinal polyps in PJS, there is little research regarding treatment of mucocutaneous melanosis. This study investigated the many advantages of using a Q-switched alexandrite laser to treat mucocutaneous melanosis. In this case, a 19-year-old male with PJS presented with labial lentigines and received two Q-switched alexandrite laser treatments in 2018. Subsequently, the efficacy of the treatment was evaluated. The result of the evaluation was that, after the two laser treatments, the labial lentigines were successfully removed, and there were no complications.     

Q-Switched Alexandrite Laser Therapy for Pigmentation of the Lips Owing to Laugier-Hunziker Syndrome

BACKGROUND: Laugier-Hunziker (LH) syndrome is a rare benign condition in which hyperpigmentation of the lips and buccal mucosa occurs with no systemic associations. OBJECTIVE: We report the response to treatment with the Q-switched alexandrite laser (QSAL) because there are few reports on therapy for LH syndrome. METHODS: The QSAL was used for pigmentation of the lips in a 63-year-old woman with LH syndrome. Laser irradiation was done at 5.0 J/cm2 with a 3 mm spot size. RESULTS: There was 100% clearance of pigmentation of the lips with a single laser treatment, and recurrence was not observed after 6 months. CONCLUSION: The QSAL is very effective for pigmentation owing to LH syndrome.     

Successful Removal of Freckles in Asian Skin with a Q-Switched Alexandrite Laser

BACKGROUND.: Although freckles are light-brown macules most frequently observed in individuals with red or blond hair and blue or gray eyes, freckles are common to Asian people, including Koreans. Treatment may be requested on cosmetic grounds. OBJECTIVE.: The objective of this study was to determine the effectiveness of the Q-switched alexandrite laser (wavelength 755 nm; pulse width 100 nsec) in treating the 197 cases of Asian skin with freckles and to observe any side effects such as pigmentary changes or scarring. METHODS.: One hundred ninety-seven patients with freckles were treated with the Q-switched alexandrite laser at 8-week intervals and clinically analyzed. RESULTS.: More than 76% removal of freckles required an average of 1.5 treatment sessions with 7.0 J/cm2. No scarring, long-standing pigmentary changes, or textural changes were seen in laser-irradiated skin. CONCLUSION.: The Q-switched alexandrite laser is a safe and highly effective modality for removing freckles without scarring or permanent pigmentary changes in Asian skin.     

Therapeutic effect of using a long-pulsed alexandrite laser system with a cooling device for epilation in reconstructive surgery of auricular malformations

Hair growth after reconstructive surgery for auricular malformations including microtia and full-thickness skin grafts poses serious problems for patients. Currently, the author and his colleagues use a long-pulsed alexandrite laser system with a cooling device to remove hair from hairy regions before and after reconstructive surgery of auricular malformations. They achieve good results with approximately two to five treatments, and report the details here. Using their protocols there were no adverse reactions such as ulceration, scarring, pigmentation, or depigmentation. The use of this system may change the technique of auricle treatment because of the advantages it offers, such as low invasiveness, high effectiveness, and safety.     

Q开关紫翠宝石激光治疗P-J综合征面部黑子15例

目的：探讨Q开关紫翠宝石激光治疗p-J综合征患者面部黑子的有效性和安全性。方法：15例P—J综合征患者,均采用Q开关紫翠宝石激光治疗,脉宽75ns,波长755nm,光斑直径2．4mm。结果：经1～3次治疗后,15例患者均取得了满意疗效,没有发生严重的并发症。结论：Q开关紫翠宝石激光是治疗p-J综合征患者面部黑子的一种安全、有效的方法。     

调Q开关紫翠宝石激光治疗40例色素沉着-肠息肉综合征唇部皮疹的疗效观察

目的:观察Q开关紫翠宝石激光治疗色素沉着-息肉综合征的唇部皮疹的疗效。方法:采用波长752nm的调Q Al exandr i t e激光Phot Geni ca HT10治疗色素沉着-肠息肉综合征面部皮疹患者40例,并观察疗效。结果:治疗总显效率达100%,治愈率达52.5%,治疗3次后大部分病例能获得痊愈。本组病例无1例出现瘢痕、色素沉着或色素减退。结论:752nm紫翠宝石激光治疗色素沉着-肠息肉综合征面部皮疹有明显的效果,是目前行之有效的较好方法。     

Analysis of 602 Chinese Cases of Nevus of Ota and the Treatment Results Treated by Q-Switched Alexandrite Laser

BACKGROUND: Nevus of Ota is a congenital or acquired pigmentary disorder of the skin and mucous membranes, which are areas innervated by the first and second branches of the trigeminal nerve. Nevus of Ota is very common in Asia. Nevus of Ota was effectively treated with Q-switched alexandrite (755 nm) laser, but no detailed report existed on many Chinese cases treated with Q-switched alexandrite laser. OBJECTIVE: The objective was to gauge clinical and treatment data and material statistics for 602 cases of nevus of Ota and analyze its pathogenic mechanism and therapeutic results. METHODS: A total of 602 cases of clinical data on nevus of Ota were collected by means of clinical registration, photo verification, and telephone inquiry or correspondence. CONCLUSIONS: There are some differences in sex, age, and local regions in nevus of Ota. Nevus of Ota can combine with other diseases. The treatment of Nevus of Ota by a Q-switched alexandrite laser is safe and effective. Additional treatment will achieve good results. The results correlate to the eyelids and Tanino's classification.     

Treatment of atrophoderma of Pasini and Pierini-associated hyperpigmentation with the Q-switched alexandrite laser: a clinical, histologic, and ultrastructural appraisal

BACKGROUND AND OBJECTIVE: Atrophoderma of Pasini and Pierini (APP) is an uncommon cutaneous disorder, with no known effective treatment, manifested by hyperpigmented patches that appear to be depressed compared with surrounding skin. This study investigated the effectiveness of the Q-switched alexandrite laser on a patient with extensive APP, and evaluated histopathologic and ultrastructural changes. STUDY DESIGN/MATERIALS AND METHODS:A man with stable APP underwent Q-switched alexandrite laser treatment to a patch on the trunk. Biopsies were obtained from treated and untreated sites of involvement. Light and transmission electron microscopic evaluation was performed to investigate melanosome number, size, and volume, as well as melanin granule number and size. RESULTS: After three treatment sessions, the treated area showed marked clinical improvement. Electron microscopy showed a 19% reduction in melanin granule number and size and a 65% reduction in melanosome number, size, and volume in larger melanosomes in treated compared with untreated sites. CONCLUSION: Treatment of APP with the Q-switched alexandrite laser results in clinical improvement. Electron microscopic evaluation suggests that the mechanism may be a reduction in the number, size, and volume of larger melanosomes as well as a decrement in melanin granule number and size.     

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.     

Areolar Cosmetic Tattoo Ink Darkening: A Complication of Q-Switched Alexandrite Laser Treatment

BACKGROUND AND OBJECTIVE: Medical tattooing of the areola is widely performed in Korea. However, cosmetic tattoos containing flesh-tone, purple-red, and yellow dyes are sometimes resistant to Q-switched laser and may even become darker. METHOD: Two Korean women in their 30s who had a mastectomy got light brown to red areolar medical tattoos but they were not satisfied with the shape and size of the tattoos. They underwent Q-switched alexandrite laser treatment with a 3 mm collimated beam at fluences of 7.5-8 J/cm2 in order to trim the irregular contour and reduce the diameter of the tattoos. RESULTS: Within 5 minutes a dark gray to black discoloration of the treated area was evident and remained dark for 6 weeks. Improvement was not noted after two further Q-switched Nd:YAG laser treatments. CONCLUSION: Medical areolar tattoos should be approached with extra caution when attempting their removal with high-energy pulsed lasers such as Q-switched alexandrite laser and a small test site should be performed prior to treatment.     

Q-switched laser treatment of tattoos

In the last decade, Q-switched lasers have expanded the clinician’s ability to treat decorative, cosmetic and traumatic tattoos without scarring. Previous methods of gross tissue removal with resultant scarring have been replaced by the highly selective removal of tattoo pigment with minimal changes in skin texture or pigmentation. This article reviews use of the Q-switched ruby, Q-switched neodymium-yttrium-aluminum-garnet and Q-switched alexandrite lasers in the clinical management of patients with tattoos.     

Use of the Q-switched alexandrite laser (755 nm, 100 nsec) for eyebrow tattoo removal.

BACKGROUND AND OBJECTIVE: Permanent tattooing for cosmetic reasons has increased in recent years; as a consequence, there has been an increase of requests for pigment removal due to complications or undesired results. The Q-switched alexandrite laser has been found useful in removing black exogenous pigment, which is the most popular color in eyebrow enhancement. We report the case of a patient with black-pigment eyebrow cosmetic tattoo after treatment with the Q-switched alexandrite laser. STUDY DESIGN/MATERIALS AND METHODS: Treatment conditions included 755-nm wavelength, 100 +/- 10-nsec pulse width, and 3-mm spot size. Fluence threshold was determined, and a spot test was made at the first visit. Single impact technique with 10% overlapping was applied to the whole tattoo. Five treatments were performed with a mean fluence of 7 J/cm(2). RESULTS: Complete pigment removal was achieved after five sessions. Superficial bleeding and vesicle formation was observed. CONCLUSIONS: Eyebrow tattooing can be treated efficiently with the use of the Q-switched alexandrite laser when black pigment has been used for cosmetic reasons.     

Treatment of nevus of Ota with the Q-switched alexandrite laser.

BACKGROUND AND OBJECTIVE: Q-switched laser systems have been shown to be useful for removal of nevus of Ota, a pigmented lesion on the face. The purpose of this study was to evaluate the efficacy of Q-switched alexandrite laser in the treatment of nevus of Ota in 13 patients. STUDY DESIGN/MATERIALS AND METHODS: A spot test was made at 6.0, 7.0, and 8.0 J/cm(2) energy fluence, and the best energy fluence was selected after a 2-month postoperative evaluation. Q-switched alexandrite laser with a mean fluence of 7.290.46 J/cm(2) was used at 8-week intervals. Total treatment ranged from 1 to 15 sessions (mean 7.1 +/- 5.1 sessions). The single shot technique was used. RESULTS: More than 75% lightening was achieved in seven patients, between 51% and 75% in three, less than 50% in one, and less than 25% in one. In two patients with excellent clearance, a very light gray macula in the lower eyelid persisted after 8 and 14 treatment sessions, respectively. Mild transient hypopigmentation that subsided spontaneously after 2 months was observed in one patient. No repigmentation was seen. CONCLUSIONS: The Q-switched alexandrite laser seems to be an effective and safe modality for the treatment of nevus of Ota.     

Use of Q-switched alexandrite laser (755 nm, 100 nsec) for removal of traumatic tattoo of different origins

BACKGROUND AND OBJECTIVES: Q-switched laser systems have been used for removal of tattoo-related carbon, graphite, and other particles. We assessed elimination of traumatic tattoos of different origin with Q-switched alexandrite laser in nine patients. STUDY DESIGN/MATERIALS AND METHODS: Fluence threshold was determined and a spot test was made. Q-switched alexandrite laser, with a fluence range 4.5-8.0 J/cm(2) (mean, 7.16 +/- 1.18), was used at 4-5-week intervals. Total treatment ranged from 3-12 sessions (mean, 6.1 +/- 3.6 sessions). Double-pulse technique was used in black/black-bluish areas, but single-shot was applied to slate-gray pigment. RESULTS: More than 95% lightening was achieved in five patients after 5.2 +/- 2.3 sessions, and >75% lightening in six subjects after 6.1 +/- 3.1 sessions of treatment. Blacktop, surgical pen, and gravel tattoos presented a better response than gunpowder/fireworks tattoos (>95% vs. 68.7 +/- 23.9% clearance), or tattoos of unknown origin (>95% vs. 62.5 +/- 53% clearance). Epidermal splattering and pinpoint bleeding were observed in one case. No pigmentary alteration or scarring was seen. CONCLUSION: The Q-switched alexandrite laser is a useful system for removal of traumatic tattoos of diverse origin. The best response (>95% clearance) was achieved in blacktop, surgical pen, and gravel tattoos, although an acceptable degree of lightening may be obtained in tattoos due to gunpowder or fireworks.