Sequential Delivery of Neodymium:Yttrium-Aluminum-Garnet and Alexandrite Laser Pulses for Treating Light Brown Seborrheic Keratoses

Seborrheic keratoses (SKs) have been treated with non-ablative longpulsed (LP) lasers, including LP 532-nm neodymium (Nd): yttrium aluminum garnet (YAG), LP 695-nm ruby, LP 755-nm alexandrite (Alex), and LP 1,064-nm Nd:YAG lasers, with a pulse durations of 1-300 msec. Dual-wavelength LP 755-nm Alex/1,064-nm Nd:YAG laser systems have been used to remove hair follicles and treat various vascular and pigmented disorders by sequentially delivering two pulses of different wavelengths with interpulse intervals in the millisecond range. This paper reports the case of a female patient with multiple, discrete, light brown SKs on the dorsum of both hands that were treated effectively with one session of dual-wavelength LP 1,064-nm Nd:YAG/755-nm Alex laser treatment. The treatment settings for the LP Nd:YAG laser were comprised of a wavelength of 1,064 nm, fluence of 50 J/cm², pulse duration of 5 msec, and beam size of 3 mm. The settings for the LP Alex laser were comprised of a wavelength of 755 nm, fluence of 50 J/cm², pulse duration of 5 msec, and beam size of 3 mm. A hybrid mode was used to automatically deliver LP Nd:YAG and LP Alex laser pulses in succession at interpulse intervals of 20 msec. Six weeks after treatment, the patient exhibited remarkable improvement of the light brown seborrheic keratoses and was satisfied with the results.