Funding sources None.
DERMATOLOGICAL SURGERY AND LASERS
Effectiveness of combined pulsed dye and Q-switched ruby laser treatment for large to giant congenital melanocytic naevi
Article first published online: 29 OCT 2012
© 2012 The Authors. BJD © 2012 British Association of Dermatologists
British Journal of Dermatology
Volume 167, Issue 5, pages 1085–1091, November 2012
How to Cite
Funayama, E., Sasaki, S., Furukawa, H., Hayashi, T., Yamao, T., Takahashi, K., Yamamoto, Y. and Oyama, A. (2012), Effectiveness of combined pulsed dye and Q-switched ruby laser treatment for large to giant congenital melanocytic naevi. British Journal of Dermatology, 167: 1085–1091. doi: 10.1111/j.1365-2133.2012.11058.x
Conflicts of interest None declared.
- Issue published online: 29 OCT 2012
- Article first published online: 29 OCT 2012
- Accepted manuscript online: 16 MAY 2012 11:05AM EST
- Accepted for publication 10 May 2012
Summary Background There is no consensus on the most appropriate treatment for patients with large to giant congenital melanocytic naevi (CMN) because of the risk of melanoma development. Surgical excision followed by skin grafting or expanded skin coverage may cause unfavourable scarring. There is a balance to be achieved between minimizing the disfiguring appearance and the risk of malignant change. The pulsed dye laser (PDL) is commonly used for vascular lesions and is highly absorbed by melanin and haemoglobin. Its pulse duration is longer than that of Q-switched ruby lasers (QsRL), which can have nonspecific photothermolytic effects on surrounding nonpigmented naevus cells.
Objectives To investigate the effectiveness of combined treatment with the PDL and QsRL for large to giant CMN.
Methods Six patients with large to giant CMN were enrolled in this study. Treatment consisted of one pass of PDL treatment followed by one pass of QsRL treatment. Multiple rounds of treatment were applied to all patients.
Results All patients responded to this combined regimen, and the lesional colour was effectively reduced. The mean number of rounds of laser treatment required to achieve skin lightening was 7·7. No patients suffered severe hypertrophic scarring. No cases of recurrence or malignant transformation were observed. The histological results from the patient who underwent the most laser therapy in this study showed a remarkable reduction in the number of melanocytic naevus cells after treatment.
Conclusions This technique may enable the removal of most of the pigmented lesion and melanocytic naevus cells with minimal scarring.