Annals of dermatology

Korean Dermatological Association (대한피부과학회)
권호 표지
DOI QR코드

DOI QR Code

Intense Pulsed Light Alone and in Combination with Erbium Yttrium-Aluminum-Garnet Laser on Small-to-Medium Sized Congenital Melanocytic Nevi: Single Center Experience Based on Retrospective Chart Review

  • Lee, Mi So (Department of Dermatology, Seoul St. Mary's Hospital) ;
  • Jun, Hee Jin (Department of Dermatology, Seoul St. Mary's Hospital) ;
  • Cho, Sang Hyun (Department of Dermatology, Incheon St. Mary's Hospital) ;
  • Lee, Jeong Deuk (Department of Dermatology, Incheon St. Mary's Hospital) ;
  • Kim, Hei Sung (Department of Dermatology, Incheon St. Mary's Hospital)
  • Received : 2016.02.19
  • Accepted : 2016.05.23
  • Published : 2017.02.01
⟨ Previous Next ⟩

Abstract

Background: Treatment of congenital melanocytic nevi (CMN) with intense pulsed light (IPL) has recently produced promising results. Objective: To evaluate the clinical and histological outcomes of small-to-medium sized CMN treated with IPL alone and in combination with erbium: yttrium-aluminum-garnet (Er: YAG) laser. Methods: We performed a retrospective chart review of 26 small-to-medium sized CMN treated as described above. The reduction in visible pigmentation, signs of recurrence and any adverse skin changes were evaluated by two independent clinicians. Results: Seventeen patients completed treatment and were followedup. Nine were not able to complete treatment due to work, change in residence, and treatment related stress. Ten patients received IPL alone (mean: 10.5 sessions) and 7 underwent treatment with IPL (mean: 7.7 sessions) and Er: YAG/IPL combination therapy (mean: 4.7 sessions). The initial treatment outcome was cleared in 5 patients and excellent in 12. Fourteen patients (82.4%) showed CMN recurrence one year after treatment completion. The histological results from a patient with an excellent clinical outcome showed remnant nevus cells nests in the deep dermis. Conclusion: IPL treatment alone and in combination with Er: YAG laser are not definitive treatments for CMN and should not be considered as first-line treatment.

Keywords

Acknowledgement

Supported by : Ministry of Health & Welfare

References

  1. Krengel S. Nevogenesis--new thoughts regarding a classical problem. Am J Dermatopathol 2005;27:456-465. https://doi.org/10.1097/01.dad.0000175532.27368.3f
  2. Kopf AW, Bart RS, Hennessey P. Congenital nevocytic nevi and malignant melanomas. J Am Acad Dermatol 1979;1:123-130. https://doi.org/10.1016/S0190-9622(79)70009-0
  3. Alikhan A, Ibrahimi OA, Eisen DB. Congenital melanocytic nevi: where are we now? Part I. Clinical presentation, epidemiology, pathogenesis, histology, malignant transformation, and neurocutaneous melanosis. J Am Acad Dermatol 2012;67:495.e1-e17.
  4. Ibrahimi OA, Alikhan A, Eisen DB. Congenital melanocytic nevi: where are we now? Part II. Treatment options and approach to treatment. J Am Acad Dermatol 2012;67:515.e1-e13.
  5. Marghoob AA, Agero AL, Benvenuto-Andrade C, Dusza SW. Large congenital melanocytic nevi, risk of cutaneous melanoma, and prophylactic surgery. J Am Acad Dermatol 2006;54:868-870. https://doi.org/10.1016/j.jaad.2006.03.008
  6. Kinsler VA, Chong WK, Aylett SE, Atherton DJ. Complications of congenital melanocytic naevi in children: analysis of 16 years' experience and clinical practice. Br J Dermatol 2008;159:907-914. https://doi.org/10.1111/j.1365-2133.2008.08775.x
  7. Dawson HA, Atherton DJ, Mayou B. A prospective study of congenital melanocytic naevi: progress report and evaluation after 6 years. Br J Dermatol 1996;134:617-623. https://doi.org/10.1111/j.1365-2133.1996.tb06959.x
  8. Berg P, Lindelof B. Congenital melanocytic naevi and cutaneous melanoma. Melanoma Res 2003;13:441-445. https://doi.org/10.1097/00008390-200310000-00002
  9. Tannous ZS, Mihm MC Jr, Sober AJ, Duncan LM. Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management. J Am Acad Dermatol 2005;52:197-203. https://doi.org/10.1016/j.jaad.2004.07.020
  10. Zaal LH, Mooi WJ, Klip H, van der Horst CM. Risk of malignant transformation of congenital melanocytic nevi: a retrospective nationwide study from The Netherlands. Plast Reconstr Surg 2005;116:1902-1909. https://doi.org/10.1097/01.prs.0000189205.85968.12
  11. Al-Hadithy N, Al-Nakib K, Quaba A. Outcomes of 52 patients with congenital melanocytic naevi treated with UltraPulse Carbon Dioxide and Frequency Doubled Q-Switched Nd-Yag laser. J Plast Reconstr Aesthet Surg 2012;65:1019-1028. https://doi.org/10.1016/j.bjps.2012.03.003
  12. Lee JM, Kim IH, Rhyu IJ, Ryu HJ. Combined intense pulsed light and Er:YAG laser treatment of congenital melanocytic nevus. J Cosmet Laser Ther 2015;17:162-164. https://doi.org/10.3109/14764172.2014.1003244
  13. Moreno-Arias GA, Ferrando J. Noncoherent-intense-pulsed light for the treatment of relapsing hairy intradermal melanocytic nevus after shave excision. Lasers Surg Med 2001;29:142-144. https://doi.org/10.1002/lsm.1100
  14. Minakawa S, Takeda H, Korekawa A, Kaneko T, Urushidate S, Sawamura D. Q-switched ruby laser therapy and longterm follow-up evaluation of small to medium-sized congenital melanocytic naevi. Clin Exp Dermatol 2012;37:438-440. https://doi.org/10.1111/j.1365-2230.2011.04226.x
  15. Lee SE, Choi JY, Hong KT, Lee KR. Treatment of acquired and small congenital melanocytic nevi with combined Er: YAG laser and long-pulsed alexandrite laser in Asian skin. Dermatol Surg 2015;41:473-480. https://doi.org/10.1097/DSS.0000000000000288
  16. Arora H, Falto-Aizpurua L, Chacon A, Griffith RD, Nouri K. Lasers for nevi: a review. Lasers Med Sci 2015;30:1991-2001. https://doi.org/10.1007/s10103-014-1697-y
  17. Moreno Arias GA, Ferrando J. Intense pulsed light for melanocytic lesions. Dermatol Surg 2001;27:397-400.
  18. Martin JM, Monteagudo C, Bella R, Reig I, Jorda E. Complete regression of a melanocytic nevus under intense pulsed light therapy for axillary hair removal in a cosmetic center. Dermatology 2012;224:193-197. https://doi.org/10.1159/000338573
  19. Raulin C, Hellwig S, Schonermark MP. Treatment of a nonresponding port-wine stain with a new pulsed light source (PhotoDerm VL). Lasers Surg Med 1997;21:203-208. https://doi.org/10.1002/(SICI)1096-9101(1997)21:2<203::AID-LSM13>3.0.CO;2-F
  20. Weiss RA, Weiss MA, Marwaha S, Harrington AC. Hair removal with a non-coherent filtered flashlamp intense pulsed light source. Lasers Surg Med 1999;24:128-132. https://doi.org/10.1002/(SICI)1096-9101(1999)24:2<128::AID-LSM8>3.0.CO;2-M
  21. Kawada A, Shiraishi H, Asai M, Kameyama H, Sangen Y, Aragane Y, et al. Clinical improvement of solar lentigines and ephelides with an intense pulsed light source. Dermatol Surg 2002;28:504-508.
  22. Goldberg DJ. Current trends in intense pulsed light. J Clin Aesthet Dermatol 2012;5:45-53.
  23. Kilmer SL, Lee MS, Grevelink JM, Flotte TJ, Anderson RR. The Q-switched Nd:YAG laser effectively treats tattoos. A controlled, dose-response study. Arch Dermatol 1993;129:971-978. https://doi.org/10.1001/archderm.1993.01680290043007
  24. Bjerring P, Christiansen K. Intense pulsed light source for treatment of small melanocytic nevi and solar lentigines. J Cutan Laser Ther 2000;2:177-181. https://doi.org/10.1080/146288300750163745
  25. Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 1983;220:524-527. https://doi.org/10.1126/science.6836297

Cited by

  1. Long-term outcomes of laser treatment for congenital melanocytic nevi vol.80, pp.2, 2017, https://doi.org/10.1016/j.jaad.2018.08.046
  2. The use of 2940‐nm ER:YAG laser for the treatment of lentigo maligna vol.17, pp.4, 2017, https://doi.org/10.1111/ddg.13814
  3. Einsatz des 2940 nm ER:YAG‐Lasers zur Behandlung der Lentigo maligna vol.17, pp.4, 2017, https://doi.org/10.1111/ddg.13814_g
  4. The outcome of using different surgical modalities and laser therapy in the treatment of small‐ and medium‐sized congenital melanocytic nevi: a systematic review vol.59, pp.5, 2017, https://doi.org/10.1111/ijd.14727
  5. Treatment of сongenital melanocytic nevus in infants and children by a dual-wavelengths copper vapor laser vol.96, pp.3, 2017, https://doi.org/10.25208/vdv1133
  6. Treatment of congenital melanocytic nevi in the periorbital area with dual-wavelength copper vapor laser vol.87, pp.None, 2017, https://doi.org/10.25259/ijdvl_654_20
  7. Cryocarboxy Surgery for the Treatment of Congenital Melanocytic Nevi of the Face, a New Addition of Simple Treatment for a Troublesome Problem vol.38, pp.4, 2021, https://doi.org/10.1177/0748806820977369