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Gallo G, Ibrahim SM, Pennati BM, Pieri L, Zingoni T, Bonan P. Q-Switched 785 nm laser in the treatment of labial melanotic macules. Skin Res Technol 2024; 30:e13581. [PMID: 38221793 PMCID: PMC10788637 DOI: 10.1111/srt.13581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024]
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Shin H, Lee Y, Hwang J, Lim S, Choi J, Gong SP, Kang HW. Effect of dual-optical pulses with temporal energy distribution on laser ablation performance in in vivo zebrafish model. JOURNAL OF BIOPHOTONICS 2023; 16:e202300232. [PMID: 37651611 DOI: 10.1002/jbio.202300232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/06/2023] [Accepted: 08/28/2023] [Indexed: 09/02/2023]
Abstract
A Q-switched laser system has been used in a single-pulse mode for skin melasma treatments because of instant heat deposition in the target. Despite the efficient ablation of the melanophores in the skin, the single, high-fluence pulse often causes undesirable damage to the surrounding tissue, leading to high recurrence rates. This study aims to investigate the feasibility of dual-optical pulses with a temporal energy distribution on the melasma treatment in in vivo zebrafish models in comparison to that of the single optical pulse. Based on the optical detection, the dual-optical pulses had a temporal energy distribution ratio of 4:1 and an interval of 61 μs between the two consecutive pulses. According to the histological analysis, the dual pulses removed melanophores and induced a few apoptotic nuclei with minimal recurrence. This study demonstrated that the feasibility of dual-optical pulses (energy ratio = 4:1) could enhance the laser ablation performance in vivo.
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Yang X, Bi C, E T, Lin L, Cao Y. A retrospective study of 1064-nm Q-switched Nd:YAG laser therapy for acquired bilateral nevus of Ota-like macules. Skin Res Technol 2023; 29:e13298. [PMID: 36973977 PMCID: PMC10155852 DOI: 10.1111/srt.13298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/16/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND The therapeutic efficacy of laser treatments for acquired bilateral nevus of Ota-like macules (ABNOM) varies among studies, and few studies have evaluated the factors affecting therapeutic effects. AIMS To evaluate the efficacy and safety of 1064-nm Q-switched Nd:YAG laser (QSNYL) therapy for ABNOM and to identify the factors influencing the outcome. METHODS A total of 110 patients with ABNOM were retrospectively evaluated and received two-to-nine treatment sessions. The effects of different factors on the therapeutic effect were analyzed on the basis of the number of treatments, age at first treatment, skin type, lesion color, affected area, number of lesion sites, and presence of concomitant melasma. RESULTS The curative effect was positively correlated with the treatment time and negatively correlated with the increasing age at first treatment (p < 0.05). The curative effect was better in patients with skin type III than those with type IV ( p < 0.05) and in patients with a lesion area of less than 10 cm2 than those with a larger affected area (p < 0.05). Additionally, the treatment effect was poorer in patients with concomitant melasma (p < 0.05). The treatment effect was not significantly correlated with the lesion color or number of affected sites (p > 0.05). Eleven patients (10%) developed postinflammatory hyperpigmentation (PIH). CONCLUSIONS Early and repeated QSNYL therapy achieved satisfactory results for ABNOM. The risk of PIH after laser treatment is highest among patients with older age, darker lesion color, and darker skin color. For patients with ABNOM with concurrent melasma, low-energy laser therapy is recommended to reduce the risk of melasma aggravation.
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Lyons AB, Moy RL, Herrmann JL. A Randomized, Controlled, Split-Face Study of the Efficacy of a Picosecond Laser in the Treatment of Melasma. J Drugs Dermatol 2019; 18:1104-1107. [PMID: 31741350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Introduction: Melasma is a common disorder where patients develop hyperpigmented macules and patches on the face and is thought to be the result of sun exposure and hormonal contributions, although the pathogenesis is not completely understood. Lasers have been used for melasma treatment with varying degrees of success. Objectives: The objective of this study was to examine the safety and efficacy of a novel picosecond laser for the treatment of melasma. Materials and Methods: Ten subjects received nine weekly laser treatments with a picosecond laser to a randomized half of their face. A lightening cream was applied to the entire face to serve as a control. The primary outcome measure was clinical efficacy measured by a patient-reported outcome survey, the Melasma Quality of Life (MELASQOL) questionnaire, and physician assessment with the Global Aesthetic Improvement Scale (GAIS). The secondary outcome measure was safety, which was assessed by monitoring for adverse events. Photos were taken before every treatment and at a 1-week follow-up. Results: Ninety percent of subjects rated their melasma as at least slightly better, and 90% percent of subjects would recommend this laser treatment to others with melasma. MELASQoL questionnaire scores improved by an average of 5.7 points after laser treatment. Assessments by two board-certified dermatologists using the GAIS revealed an overall improvement in 80% of patients on the laser treatment side versus 20% on the control side. Side effects, including erythema and discomfort, were minimal and transient post-treatment. Conclusions: This study suggests that picosecond laser treatments are a safe and efficacious way to treat melasma. J Drugs Dermatol. 2019;18(11):1104-1107.
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Sami L, Changzheng H, Yan L. Factors affecting response, number of laser sessions and complications in nevus of Ota treated by Q-switched alexandrite laser: a retrospective study. GIORN ITAL DERMAT V 2016; 151:160-168. [PMID: 25747257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND The aim of this study was to study and analyze the factors influencing the treatment response to Q-switched alexandrite laser in patients with nevus of Ota and the factors influencing the number of laser sessions. METHODS Forty-eight patients treated with Q-switched alexandrite between 2009 and 2013 for nevus of Ota were enrolled in this retrospective, single-center study. The subjects (13 male, 35 female) were divided into three groups according to the number of treatment sessions. Patients were then called back to the hospital for a follow-up interview and examination. Single and multiple variate analyses of various factors were performed. RESULTS The 48 patients were predominantly female (35 female, 13 male, F:M ratio = 2.7:1), mean age 17.2±10.41. Twenty-five (52.1%) had lesion on the right side of the face, 22 (45.8%) on the left side, and one (2.1%) on both sides. The predominant color was brown (41.7%), followed by cyan (39.6%) and lividity (18.8%). Satisfactory result was observed in all patients, after 3 to 11 treatment sessions (mean 5.37±2); 19 of these (39.6%) needed three to four sessions (short treatment sessions), 22 (45.8%) needed five to seven sessions (intermediate treatment sessions), and 7 (14.6%) needed nine to eleven sessions (long treatment sessions). The clinical response and treatment sessions of the young-age group were significantly better than the adult group. Those with higher Tanino's classification needed more treatment sessions. Dark-colored lesions, which reflect deep melanosis of the lesion, needed more sessions than lighter-colored lesions. As for skin color, better response was obtained in light-skinned patients than in dark-skinned ones. Two patients showed transient hypopigmentation that lasted for less than six months, and recurrence has been seen in one child with dark-colored lesion. CONCLUSIONS Q-switched alexandrite laser is an ideal minimally-invasive method for treating nevus of Ota. Fewer treatment sessions are needed for children and younger patients, whereas brown lesion, lower Tanino's classification and light skin patients.
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Kahn S, Warso MA, Aronson IK. A hyperpigmented perianal nodule. Dermatol Online J 2013; 19:18178. [PMID: 24011278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 05/14/2013] [Indexed: 06/02/2023] Open
Abstract
Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Ultraviolet light is an important risk factor for the pathogenesis of BCCs; the vast majority are found in sun-exposed areas. BCCs occurring in the perianal or genital regions are seldom seen. Less than 1% of all BCCs occur at these sites. Etiologic factors other than solar exposure must be taken into account for such cases. We report a rare case of BCC that was initially detected during a routine colonoscopy.
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Parwani S, Parwani R. Achieving better esthetics by gingival de-pigmentation: report of three cases with a review of the literature. THE JOURNAL OF THE MICHIGAN DENTAL ASSOCIATION 2013; 95:52-78. [PMID: 23556274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A smile expresses a feeling of joy and success and also reveals self-confidence and kindness in an individual. A holistic smile is dictated not only by the shape, position and color of the teeth but also by the health of the gingival tissues. Gingival appearance is an important component of an attractive smile. Melonin, carotene and hemoglobin are the most common natural pigments contributing to the normal color of gingiva. Although physiologic and ethnic melanin pigmentation is not a medical problem, complaints about "black gums" are common. For de-pigmentation of gingiva, different treatment modalities have been reported such as bur abrasion, scraping with scalpel, partial thickness flap, gingivectomy, cryotherapy, electrosurgery, lasers, free gingival autografting, sub-epithelial connective tissue graft and combination techniques. In the present case reports, scalpel surgery and electrosurgery were performed for gingival de-pigmentation, which are simple and effective. The esthetic results were pleasing and healing was uneventful. Patients were satisfied with the outcome at three month follow-up as evidenced from their feedback.
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Abstract
PURPOSE To report the clinical and histologic features of cystic benign melanosis. METHODS This case series reports on the clinical and histopathologic features of 3 patients with enlarging, cystic, brown, pigmented, conjunctival lesions. RESULTS Slit-lamp examination showed cystic melanotic lesions of bulbar conjunctiva. Histopathologic examination of the biopsy specimens showed epithelial lined cysts in the substantia propria, goblet cells, and secondary pigmentation of basilar keratinocytes. CONCLUSIONS Cystic benign melanosis, a unique conjunctival lesion, should be differentiated from cystic nevus and primary acquired melanosis.
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Kasagani SK, Nutalapati R, Mutthineni RB. Esthetic depigmentation of anterior gingiva. A case series. THE NEW YORK STATE DENTAL JOURNAL 2012; 78:26-31. [PMID: 22803273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Gingival melanin pigmentation occurs in people of all races. Although clinical melanin pigmentation does not present a medical problem, demand for cosmetic therapy is commonly made by fair-skinned people with gingival melanin pigmentation. This problem is aggravated in patients with a "gummy smile" or excessive gingival display while smiling. Esthetic periodontal plastic surgery is especially successful in individuals with compromised esthetics. Three cases are reported here where gingival depigmentation was done using three different techniques: electrosurgery; scalpel surgery; and surgical abrasion. The clinical results of the three methods have been compared.
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Kinsler VA, Paine SML, Anderson GW, Wijesekara DS, Sebire NJ, Chong WK, Harkness W, Aylett SE, Jacques TS. Neuropathology of neurocutaneous melanosis: histological foci of melanotic neurones and glia may be undetectable on MRI. Acta Neuropathol 2012; 123:453-6. [PMID: 22294043 PMCID: PMC3282914 DOI: 10.1007/s00401-012-0945-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Revised: 01/17/2012] [Accepted: 01/18/2012] [Indexed: 01/28/2023]
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Karydis A, Bland P, Shiloah J. Management of oral melanin pigmentation. THE JOURNAL OF THE TENNESSEE DENTAL ASSOCIATION 2012; 92:10-17. [PMID: 23420974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Melanin is an endogenous pigment responsible for human tissue coloration of the skin, mucosa, hair, eyes and parts of the brain. In the skin, its function is protection from the harmful effects of UV radiation. Its purpose in oral tissues has not yet been determined. Oral pigmentation could be an esthetic issue for some patients, particularly when it is located on the anterior labial gingiva in individuals with a high smile line. This article presents and describes several different approaches for the management of oral melanin pigmentation.
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Abstract
The term Asian refers to East Asians of the Pacific Rim who share not only a common heritage and skin type but also the same set of clinical skin problems. Pigmentation of the skin is often considered the number one esthetic skin concern in Asians. Asians idealize unblemished complexion of facial skin and are less tolerant to facial dyschromia than White. The problems of ephelides (freckles), nevi of Ota, and melasma are common and difficult to treat. This article reviews laser treatment of pigmented lesions in Asians.
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Neeley MR, Pearce FB, Collawn SS. Successful treatment of malar dermal melasma with a fractional ablative CO2laser in a patient with type V skin. J COSMET LASER THER 2010; 12:258-60. [PMID: 21142733 DOI: 10.3109/14764172.2010.538412] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Puppa G, Colombari R. Brown colon (melanosis coli) harbouring pale tumors (adenocarcinoma and an adenomatous polyp). JOURNAL OF GASTROINTESTINAL AND LIVER DISEASES : JGLD 2009; 18:509-511. [PMID: 20076832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Wanitphakdeedecha R, Manuskiatti W, Siriphukpong S, Chen TM. Treatment of Melasma Using Variable Square Pulse Er: YAG Laser Resurfacing. Dermatol Surg 2009; 35:475-81; discussion 481-2. [PMID: 19250309 DOI: 10.1111/j.1524-4725.2009.01066.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sherman JA, Gürkan A, Arikan F. Radiosurgery for gingival melanin depigmentation. DENTISTRY TODAY 2009; 28:118-121. [PMID: 19323336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Fukui S, Nakai Y, Hajikano S, Takahashi E, Hirayama A, Fujimoto K, Hirao Y. [A case of premalignant melanosis of the vagina recurring urethral orifice and intrapelvic retroperitoneum with malignant transformation]. HINYOKIKA KIYO. ACTA UROLOGICA JAPONICA 2008; 54:681-684. [PMID: 19048936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A 67-year-old female who had undergone hysterectomy and colpectomy due to vaginal premalignant melanosis presented with sacralgia after 2-year discontinuation of follow-up. Mucosal pigmentation was observed around the external urethral orifice, strongly implying recurrence of premalignant melanosis. Magnetic resonance imaging for abdominal screening revealed a cystic mass adjacent to the urinary bladder with heterogeneous internal signal measuring 5 cm in diameter, but no definitive diagnosis could be made. She underwent urethrectomy and cystostomy, with simultaneous extirpation of the intrapelvic cystic tumor. The mucosal pigmentation included atypical melanocytes, and histologically the intrapelvic cystic tumor containing melanin-rich fluid demonstrated existence of malignant melanocytes. She received adjuvant DAV-Feron immunochemotherapy using dacarbazine, nimustine, vincristine and interferon-beta. She has been followed up for 14 months without any evidence of local recurrence or metastasis.
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Malik Rahman A, Augsburger JJ, Corrêa ZM. Iridociliary melanoma associated with ocular melanocytosis in a 6-year-old boy. J AAPOS 2008; 12:312-3. [PMID: 18359649 DOI: 10.1016/j.jaapos.2008.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2007] [Revised: 01/12/2008] [Accepted: 01/17/2008] [Indexed: 11/18/2022]
Abstract
A previously healthy 6-year-old boy presented to the ophthalmologist and was found to have congenital ocular melanocytosis associated with uveal melanoma. He was treated with enucleation of the affected eye and has shown no evidence of tumor recurrence or metastasis through over 20 years of postenucleation follow-up. Ocular melanocytosis can be associated with uveal melanoma even in young children.
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Shields JA, Shields CL, Mashayekhi A, Marr BP, Benavides R, Thangappan A, Phan L, Eagle RC. Primary Acquired Melanosis of the Conjunctiva: Risks for Progression to Melanoma in 311 Eyes. Ophthalmology 2008; 115:511-519.e2. [PMID: 17884168 DOI: 10.1016/j.ophtha.2007.07.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Revised: 05/28/2007] [Accepted: 07/03/2007] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To evaluate the clinical features and risks for transformation of conjunctival primary acquired melanosis (PAM) into melanoma. DESIGN Noncomparative case series. PARTICIPANTS Three hundred eleven eyes with conjunctival PAM without melanoma at initial examination from a single-center tertiary referral center. METHODS Retrospective chart review with evaluation of the clinical features of PAM at initial presentation and follow-up. Times to PAM enlargement, recurrence, and transformation into melanoma were assessed using Kaplan-Meier estimates. Risk factors for these outcomes were analyzed using Cox proportional hazards regressions. MAIN OUTCOME MEASURES Primary acquired melanosis enlargement, recurrence, and transformation into melanoma. RESULTS Mean patient age at diagnosis of PAM was 56 years (range, 15-90), 62% were female, and 96% were Caucasian. The conjunctival quadrant(s) affected by PAM were temporal (57%), inferior (45%), nasal (42%), and superior (37%). The anatomic location(s) of PAM included bulbar conjunctiva (91%), limbal conjunctiva (55%), cornea (23%), forniceal conjunctiva (13%), palpebral conjunctiva (12%), and caruncle (11%). Primary acquired melanosis extended for a mean of 3 clock hours (range, 1-12). Initial management included observation (n = 194 eyes [62%]), biopsy combined with cryotherapy (n = 107 eyes [34%]), and topical chemotherapy and/or cryotherapy without biopsy (n = 10 [4%]). Of PAM that was observed, Kaplan-Meier estimates at 10 years revealed PAM enlargement in 35% and transformation into melanoma in 12%. Of those that underwent incisional or excisional biopsy, 10-year estimates of PAM recurrence and transformation into melanoma were 58% and 11%, respectively. Progression to melanoma occurred in 0% of cases of PAM without atypia, 0% of cases of PAM with mild atypia, and 13% of cases of PAM with severe atypia. Of the 9 patients with PAM who developed melanoma, none have developed systemic metastasis. Multivariable analysis revealed that the most significant factor for both PAM recurrence and progression to melanoma was extent of PAM in clock hours. CONCLUSION Primary acquired melanosis without atypia or with mild atypia shows 0% progression to melanoma, whereas PAM with severe atypia shows progression to melanoma in 13%. The greater the extent of PAM in clock hours, the greater the risk for transformation to melanoma.
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Goldberg DJ, Berlin AL, Phelps R. Histologic and ultrastructural analysis of melasma after fractional resurfacing. Lasers Surg Med 2008; 40:134-8. [PMID: 18306153 DOI: 10.1002/lsm.20591] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Taub AF. Fractionated delivery systems for difficult to treat clinical applications: acne scarring, melasma, atrophic scarring, striae distensae, and deep rhytides. J Drugs Dermatol 2007; 6:1120-1128. [PMID: 18038500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Fractional resurfacing or laser therapy (FLT) represents a technology that seeks to address the limitations of both ablative resurfacing and nonablative treatments. Many companies now offer versions of fractionated erbium or carbon dioxide lasers. The purpose of this paper is to examine FLT for difficult to treat applications such as melasma, acne scarring, atrophic scarring, striae distensae, and deep rhytides. Fractional laser therapy is a truly novel approach to many conditions, especially those with dermal pathology. Although published peer review data is limited, the ability to effectively and safely treat these conditions in all skin types appears to have been significantly enhanced with this new modality. We are early in our scientific explorations of what is possible with FLT.
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Liu YL, Nie ZY, Lu LJ, Hui YZ. [Peritoneal "melanosis": report of a case]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2007; 36:572-573. [PMID: 17980113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Watson A, Malhotra R, Allen J, Luthert P, Mulhern M, Daya S. A non-invasive pigmented nodule arising within primary acquired melanosis--an unusual phenomenon. Orbit 2007; 26:57-9. [PMID: 17510875 DOI: 10.1080/01676830600666144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We report a case of a raised pigmented nodule that arose within conjunctival primary acquired melanosis (PAM). This nodule showed no histological features of invasive disease.
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Azzeh MM. Treatment of Gingival Hyperpigmentation by Erbium-Doped:Yttrium, Aluminum, and Garnet Laser for Esthetic Purposes. J Periodontol 2007; 78:177-84. [PMID: 17199556 DOI: 10.1902/jop.2007.060167] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The normal color of gingiva is pink. Gingival hyperpigmentation is mostly caused by the physiologic deposition of melanin by melanocytes. In "gummy smile" patients, melanin gingival hyperpigmentation causes an esthetic problem and may cause physiologic disturbances. Methods to remove gingival hyperpigmentation vary, but it seems that the most reliable and satisfactory procedure is laser ablation. METHODS Six white patients (five females and one male), who complain of having dark-brown to black gingival hyperpigmentation were included in the study. Three of them were smokers. Laser ablation was performed by an erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser (settings: 250 mJ, 15 Hz, with water and air and using the defocused mode) without using topical or local anesthesia. Each patient required about 20 to 25 minutes for completion of the procedure. After 4 days, another laser ablation (with the same previous settings) was performed to ensure good results. Patients were evaluated a month after completion of treatment and on a semiannual basis. The follow-up period ranged between 6 and 18 months. RESULTS In all patients, no discomfort, pain, or bleeding complications were found intraoperatively or 4 days postoperatively. Ablated wounds healed almost completely within 4 days. No recurrence of gingival hyperpigmentation was found during the follow-up periods. Achieved results were satisfactory for patients and the operator. CONCLUSIONS Taking into account the advantages of using lasers, it seems to be that the depigmentation of melanin hyperpigmented gingiva by the Er:YAG laser is a reliable and satisfactory procedure. Esthetic results were satisfactory for patients and the operator, and no repigmentation was found during the follow-up period.
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