the efficacy and safety of short pulse erbium:yag laser in the treatment of acquired melanocytic...

THE EFFICACY AND SAFETY OF SHORT PULSE ERBIUM:YAG LASER

IN THE TREATMENT OF ACQUIRED MELANOCYTIC NEVI

THE EFFICACY AND SAFETY OF SHORT PULSE ERBIUM:YAG LASER

IN THE TREATMENT OF ACQUIRED MELANOCYTIC NEVI

Mete Baba*, Deniz Seçkin*, Nebil Bal**Başkent University Faculty of Medicine Department of Dermatology* and Pathology**

Mete Baba*, Deniz Seçkin*, Nebil Bal**Başkent University Faculty of Medicine Department of Dermatology* and Pathology**

No study evaluating the efficacy and safety of an erbium:YAG laser with its small penetration depth and fewer adverse effects in the treatment of acquired melanocytic nevi.

Objective Objective

To investigate the efficacy and safety of short pulse erbium:YAG laser in the treatment of acquired melanocytic nevi

Patients and MethodsPatients and Methods

Patient selection and consent

Laser treatment

Follow-up

Biopsy and histopathologic assessment

Inclusion criteriasInclusion criterias

Benign-appearing melanocytic nevi (clinically and dermatoscopically)

Nonfacial localization

Diameter < 6 mm

Flat or just palpable

Lazer treatmentLazer treatment

1 J

5 Hz

300 µs

2940 nm

Follow-upFollow-up

Wound healing

Infection

Scarring

Pigmentary changes

Biopsy and histopathologic assessment

Biopsy and histopathologic assessment

Biopsy (punch)

Histochemical examinationH&EMasson-Fontana

Immunohistochemical examinationS-100HMB-45

ResultsResults

14 patients (10 women and 4 men; aged, 21-38 years; mean, 32.6 years).

Four to ten pulses of laser irradiation were sufficient for clinical removal of all nevi

Epithelization time was between 7 and 10 days

Redness persisted up to 3 weeks in all cases

Results-SafetyResults-Safety

Infection; no

Postinflammatory hyperpigmentation; 2 cases

Hypopigmentation; 3 cases

Results-EfficasyResults-Efficasy

Complete removal; clinically; all of the nevi, and histopathologically, 27 of 28 nevi

Nevus cells located in dermis (at a depth of 0,25mm); only one specimen

Findings-HistopathologyFindings-Histopathology

Epidermis; normal

Dermis; mild fibrosis ranging between 0.19-0.28 mm (mean, 0.24 mm)

Perivascular lymphocyte and eosinophil infiltration; 7 specimens

Several melanophages; 4 specimens

Discussion-EfficasyDiscussion-EfficasyThe depth of vaporization; 2-4 µm for each 1 J/cm2,

4 to 10 pulses of erbium:YAG laser irradiation at fluencies between 5.2 and 14.4 J/cm2 are sufficient to remove nevus cells in the dermo-epidermal junction and the upper dermis.

In 1 nevus in this study, incomplete

Discussion-SafetyDiscussion-Safety

Melanin pigment içeriği az olan nevüs hücrelerinde yeterli harabiyetin oluşmaması

Epidermal pigment yoğunluğunun blokaj etkisi nedeni ile lazer ışınlarının daha alt seviyelerdeki nevüs hücrelerine ulaşamaması

Malignant transformationMalignant transformation

Laser ? Malignant

transformation

Erbium: YAG lazer; safe and effective