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Bajaj S, Orbuch D, Wang JV, Biesman BS, Geronemus RG. Interventional and device treatment of the periocular area. Clin Dermatol 2024:S0738-081X(24)00008-7. [PMID: 38336142 DOI: 10.1016/j.clindermatol.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
Growth in the research, innovation, and development of laser and energy-based technologies over the past few decades has led to dramatic increases in treatment options for dermatologic and cosmetic concerns of the periorbital area. We highlight recent treatment options using laser and energy-based devices for the clearance of periocular pigmented lesions, including solar lentigines and nevus of Ota; vascular lesions, including port-wine birthmarks, infantile hemangiomas, superficial telangiectasias, and reticular veins; laser ablation of benign tumors, such as xanthelasma; cosmetic rejuvenation; treatment of infraorbital dark circles and festoons; laser removal of eyebrow and eyeliner tattoos; and device-based treatment of chronic dry eyes.
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Affiliation(s)
- Shirin Bajaj
- Laser & Skin Surgery Center of New York, New York, New York, USA
| | - David Orbuch
- Laser & Skin Surgery Center of New York, New York, New York, USA
| | - Jordan V Wang
- Laser & Skin Surgery Center of New York, New York, New York, USA.
| | - Brian S Biesman
- Nashville Centre for Laser and Facial Surgery, Nashville, Tennessee, USA
| | - Roy G Geronemus
- Laser & Skin Surgery Center of New York, New York, New York, USA
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2
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Kubicki SL, Guo EL, Richmond H, Friedman PM. Treatment of Nevus of Ota in Black patients with the 1064 nm QS or picosecond laser and nonablative fractional photothermolysis. Lasers Surg Med 2023; 55:67-72. [PMID: 36124432 DOI: 10.1002/lsm.23597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/09/2022] [Accepted: 08/23/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Nevus of Ota is a benign melanocytic lesion that presents as a unilateral blue gray to brown facial patch favoring the distribution of the first two branches of the trigeminal nerve. Incidence is highest in Asian and Black populations, however, the overwhelming majority of studies are limited to diagnosis and treatment in Asian patients. We herein present 10 Black patients with Fitzpatrick skin types (FST) V and VI who underwent laser treatment for Nevus of Ota. METHODS We performed a retrospective review of Black patients presenting with Nevus of Ota. Race was self-designated by all patients and documented in the medical record at the time of initial consultation. Primary outcomes were based on improvement using before and after photographs which were graded by three independent board-certified dermatologists using a 5-point visual analog scale. RESULTS Ten FST V or VI patients with an age range of 9 months to 45 years were treated for Nevus of Ota. All patients were treated with the 1064 nm Q-switched neodymium doped yttrium aluminum garnet (QS Nd:YAG) and on average received 4.7 treatments at 2-10 month intervals. Fluence ranged from 1.8 to 2.3 J/cm2 , and total pulse count ranged from 510.9 to 776.6. 2/10 patients were additionally treated with 1550 nm nonablative fractional resurfacing (NAFR), and 1/10 patients underwent combination therapy with both NAFR and 1064 nm picosecond laser therapy. Overall, patients saw a mean improvement of 51%-75% at follow-up 5-254 weeks (mean 51.5 weeks) after treatment. Three patients experienced mild guttate hypopigmentation in treated areas. No other long-term adverse events were encountered. CONCLUSION 1064 nm QS Nd:YAG laser therapy is a safe and efficacious treatment for Nevus of Ota in patients with FST V and VI. When patient improvement plateaus, combining therapy with 1550 nm NAFR or transitioning to 1064 nm picosecond laser may be of benefit. Patients should be counseled on the risk of guttate hypopigmentation. This is the largest case series to date of Black patients with Nevus of Ota, highlighting the need for further investigation to determine optimal device settings and treatment parameters for this population.
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Affiliation(s)
- Shelby L Kubicki
- Department of Dermatology, McGovern Medical School, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Emily L Guo
- Dermatology & Laser Surgery Center, Houston, Texas, USA
| | | | - Paul M Friedman
- Department of Dermatology, McGovern Medical School, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,Dermatology & Laser Surgery Center, Houston, Texas, USA.,Department of Dermatology, Weill Cornell Medical College, Houston Methodist Hospital, Houston, Texas, USA
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3
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Yang H, Guo L, Jia G, Gong X, Wu Q, Zeng R, Zhang M, Ding H, Fang F, Zheng H, Liu X, Ge Y, Yang Y, Lin T. Treatment of nevus of Ota with 1064 nm picosecond Nd:YAG laser: A retrospective study. Dermatol Ther 2021; 34:e15152. [PMID: 34609042 DOI: 10.1111/dth.15152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/17/2021] [Accepted: 10/01/2021] [Indexed: 01/19/2023]
Abstract
Nevus of Ota has been successfully treated by lasers. Currently, 1064 nm picosecond Nd:YAG lasers have become available for the treatment of pigmented disorders. However, there are few studies concerning the application of 1064 nm picosecond Nd:YAG laser in nevus of Ota. This study aimed to evaluate the efficacy and safety of a 1064 nm picosecond Nd:YAG laser for the treatment of nevus of Ota. We conducted a retrospective analysis of Chinese patients with nevus of Ota who had been treated with a 1064 nm picosecond Nd:YAG laser. Those who had any other laser treatment during the period of picosecond laser treatment were excluded. Via a visual analog scale for percentage of pigmentary clearance in standard photographs, the treatment efficacy was assessed by three blinded physician evaluators. A total of 16 subjects were included in this retrospective study. The average age at the beginning of treatment was 16.87 years old (range of 4 months to 59 years), and all patients were of Fitzpatrick skin type IV. Total treatment ranged from 1 to 5 sessions. A 1064 nm picosecond Nd:YAG laser with a mean fluence of 1.8-4.3 J/cm2 was used at 3-12 month intervals. The mean efficacy score for all 16 patients was 2.56 after one session, and the mean efficacy score of 13 patients who completed two sessions and nine patients who completed three sessions were 3.15 and 3.51, respectively. Postinflammatory hyperpigmentation after treatment was only observed in 1 (1/16, 6.25%) patient. The 1064 nm picosecond Nd:YAG laser is an effective and safe approach for treating nevus of Ota.
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Affiliation(s)
- Hedan Yang
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Lifang Guo
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Gaorong Jia
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Xiangdong Gong
- Division of Sexually Transmitted Disease Epidemiology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Qiuju Wu
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Rong Zeng
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Mengli Zhang
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Hui Ding
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Fumin Fang
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Huiying Zheng
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Xing Liu
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Yiping Ge
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Yin Yang
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Tong Lin
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu, China
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1064 nm Nd:YAG laser treatment of melanocytic nevi of the external auditory canal: a retrospective study of 15 cases. Lasers Med Sci 2020; 35:2009-2014. [PMID: 32533471 DOI: 10.1007/s10103-020-03034-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Abstract
The aim of this study was to evaluate the efficacy and safety of 1064 nm neodymium-doped yttrium-aluminum-garnet laser treatment of melanocytic nevus of the external auditory canal. Retrospective chart review of 15 patients operated by 1064 nm Nd:YAG laser in single center. Data from charts and video documentation were collected and analyzed. Between November 2017 and November 2018, 15 patients underwent 1064 nm Nd:YAG laser treatment for melanocytic nevus of the external auditory canal were analyzed in the study. The size of melanocytic nevus ranged from 4 to 8 mm in diameter. A gross total removed was achieved in all cases. Two patients received two sessions of Nd:YAG laser treatments, and the remaining thirteen patients received only one session. After laser treatment, wounds healing well and the average epithelialization time was 2.3 weeks. The mean follow-up was 12 months. There were no recurrence and adverse side effects in all cases. This research supports the use of 1064 nm Nd:YAG laser as a safe and efficacious treatment for melanocytic nevus of the external auditory canal.
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Cho MY, Roh MR. Successful Treatment of Riehl's Melanosis With Mid‐Fluence Q‐Switched Nd:YAG 1064‐nm Laser. Lasers Surg Med 2020; 52:753-760. [DOI: 10.1002/lsm.23214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2019] [Indexed: 01/25/2023]
Affiliation(s)
- Mi Yeon Cho
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute Yonsei University College of Medicine 211 Eonjuro Gangnam‐gu Seoul 06273 Korea
| | - Mi Ryung Roh
- Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute Yonsei University College of Medicine 211 Eonjuro Gangnam‐gu Seoul 06273 Korea
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Nam JH, Min JH, Kim WK, Yim S, Kim WS. Melanogenesis inhibition in mice using a low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser: a pilot study. Lasers Med Sci 2017; 32:1063-1069. [PMID: 28429191 DOI: 10.1007/s10103-017-2208-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 04/06/2017] [Indexed: 01/13/2023]
Abstract
A low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminum garnet laser, or laser toning, has yielded favorable outcomes in various benign pigmented disorders. However, the exact mechanism of action of laser toning has not been fully elucidated. We sought to determine the inhibitory effect of laser toning on melanogenesis and to assess how laser passes influence the outcomes. To produce perceptible pigmentation, nine HRM-2 melanin-possessing hairless mice were treated with ultraviolet (UV) B radiation on the dorsal skin. This was followed by zero, two, four, or six passes of laser toning twice in 2 weeks on each designated quadrant. The spectrophotometric values and pigmentation-related protein expressions were measured. Pigment changes were found in the mice skin using the Fontana-Masson stain for histopathological analysis. Four- and six-pass laser toning significantly improved the lightness compared to that in the unirradiated control (p < 0.002). The Fontana-Masson stain showed that melanin was considerably decreased in laser-irradiated skin. As the number of laser passes increased, the expression of tyrosinase decreased (p < 0.008). The following parameters also decreased in proportion to the number of laser passes: MITF, TRP-1, TRP-2, p-ERK, and p-Akt. In contrast, TGF-β increased in proportion to the number of laser passes. However, the changes in these six proteins were not statistically significant. Our study demonstrates that laser toning improves skin pigmentation with increased number of passes in a dose-dependent manner. This effect is mediated by tyrosinase inhibition.
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Affiliation(s)
- Jae-Hui Nam
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Medical Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Joon Hong Min
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Medical Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Wang-Kyun Kim
- College of Pharmacy, Yonsei University, Incheon, South Korea
| | - Sunmin Yim
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won-Serk Kim
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Medical Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Liu Y, Zeng W, Geng S. A Retrospective Study on the Characteristics of Treating Nevus of Ota by 1064-nm Q-switched Neodymium-doped Yttrium Aluminum Garnet Laser. Indian J Dermatol 2016; 61:347. [PMID: 27293272 PMCID: PMC4885205 DOI: 10.4103/0019-5154.182470] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The Q-switched neodymium-doped yttrium aluminum garnet (QS Nd:YAG) laser has a significant effect in treating nevus of Ota, but there is lack of a retrospective study about the characteristics of efficacy. AIMS AND OBJECTIVES To retrospectively analyze the correlation between the clinical characteristics and efficacy, complications, recurrence of QS Nd:YAG laser in treating nevus of Ota. MATERIALS AND METHODS One hundred and seventy-one Chinese patients (144 female, 27 male) of nevus of Ota were treated with the 1064-nm QS Nd:YAG laser. All cases were treated with fluencies of 4-8 J/cm(2) and a spot size of 2-4 mm. Clinical photographs were taken before every treatment and patients were followed up by their clinicians. RESULTS One hundred and forty-five patients (84.8%) acquired more than 75% improvement with an average of 4.6 sessions. The treatment effect has no significant correlation with sex (P > 0.05). The blue-black and brown lesions improved more than the light-brown (P < 0.05). Hyperpigmentation affected two (1.2%) of the patients and hypopigmentation affected one patient (0.6%). No other adverse effect was observed. Recurrence was seen in two patients (1.2%). CONCLUSION The 1064-nm QS Nd:YAG laser is effective with rare complications and recurrence in the treatment of nevus of Ota. The efficacy correlated with lesion color, which is meaningful to estimate the prognosis.
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Affiliation(s)
- Yanting Liu
- Department of Dermatology, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Weihui Zeng
- Department of Dermatology, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
| | - Songmei Geng
- Department of Dermatology, Northwest Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China
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Abstract
Advances in laser technology in recent decades have increased the options for the treatment of dermatologic conditions of the eye and eyelid. Benign tumors can be laser-ablated with relative ease, and vascular and melanocytic lesions can be precisely targeted with modern lasers. In this contribution, we review treatment of periocular pigmented lesions, including melanocytic nevi and nevus of Ota; vascular lesions including telangiectasias, port wine stains, and infantile hemangiomas; hair removal; eyeliner tattoo removal; laser ablation of common benign periocular tumors, such as syringomas, xanthelasma, milia, and seborrheic keratoses; and laser resurfacing. The recent advent of fractionated laser technology has resulted in dramatically decreased healing times for periocular skin resurfacing and fewer adverse effects. Fractionated laser resurfacing has now nearly supplanted traditional full-field laser resurfacing, and safe treatment of rhytides on the thin skin of the eyelids is possible. Proper eye protection is, of course, essential when using lasers near the eye. Patient preparation, safety precautions, and risks--intraocular and extraocular--are discussed herein. As laser technology continues to advance, we are sure to see improvements in current treatments, as well as development of new applications of cutaneous lasers.
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Affiliation(s)
- Breton Yates
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, Farmington, Connecticut
| | - Syril Keena T Que
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, Farmington, Connecticut
| | - Logan D'Souza
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, Farmington, Connecticut
| | - Jeanine Suchecki
- Division of Ophthalmology, University of Connecticut Health Center, Department of Surgery, 263 Farmington Avenue, Farmington, Connecticut
| | - Justin J Finch
- Department of Dermatology, University of Connecticut Health Center, 21 South Road, Farmington, Connecticut.
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Choi JE, Lee JB, Park KB, Kim BS, Yeo UC, Huh CH, Kim JH, Kye YC. A retrospective analysis of the clinical efficacies of Q-switched Alexandrite and Q-switched Nd:YAG lasers in the treatment of nevus of Ota in Korean patients. J DERMATOL TREAT 2014; 26:240-5. [PMID: 24888365 DOI: 10.3109/09546634.2014.930409] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND While the Q-switched Alexandrite laser (QSAL) and the Q-switched neodymium: yttrium-aluminum-garnet (QSNY) laser have been widely used in treating nevus of Ota, few studies compared them. OBJECTIVE To compare the efficacies of the QSAL and the QSNY laser in the treatment of nevus of Ota in Korean patients. METHODS AND MATERIALS A retrospective multicenter study was conducted in 76 patients with nevus of Ota. Thirty-one patients were treated with a QSAL (5.5-8.0 J/cm(2), 4-mm spot size) and 45 patients were treated with QSNY laser (6.0-12.0 J/cm(2), 2-mm spot size). Treatment outcomes were categorized into five grades and the results were compared with the relevant variables taken into account using multivariate logistic regression analysis. RESULTS QSAL treatment was more likely to achieve a better response compared with that with QSNY laser treatment. The odds ratio of achieving an excellent response, compared with the odds ratio of having a poor response, was 12.213-times more likely when a QSAL was used than when a QSNY laser was used (p = 0.026). CONCLUSION The QSAL tends to be more efficient than the QSNY laser in the treatment of nevus of Ota in Korean patients. Further controlled, prospective comparison studies are needed.
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Affiliation(s)
- Jae Eun Choi
- Department of Dermatology, College of Medicine, Korea University , Seoul , Korea
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Sethuraman G, Sharma VK, Sreenivas V. Melanin Index in Assessing the Treatment Efficacy of 1064 nm Q Switched Nd-Yag Laser in Nevus of Ota. J Cutan Aesthet Surg 2014; 6:189-93. [PMID: 24470713 PMCID: PMC3884881 DOI: 10.4103/0974-2077.123398] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Q-switched neodymium-yttrium aluminium-garnet (Q switched Nd-Yag) laser has been used in the treatment of nevus of Ota in all skin types with variable success rate. Data with an objective assessment parameter to this laser treatment is lacking. Objective: To evaluate the utility of melanin index in assessing the treatment response and also determine the efficacy and safety of the Q-switched Nd-Yag laser (1064-nm) in the treatment of nevus of Ota in Fitzpatrick skin types IV and V. Materials and Methods: A total of 35 patients treated with Nd-Yag laser were studied. The objective improvement (pigment clearance) was determined by melanin index from two fixed points: A1, 2 cm below the pupil at the mid pupillary line (when the gaze is fixed); A2, the most prominent part of zygoma. The melanin index in these two areas was recorded as M1 and M2, respectively. The subjective clinical improvement was determined by the physician and the patient global assessment score. Results: The mean baseline melanin indices M1 and M2 were 59.54 ± 9.72 and 59.02 ± 9.16, respectively. At the last visit the mean M1 and M2 decreased to 53.8 ± 8.55 (P < 0.001) and 54.13 ± 6.01 (P < 0.001), respectively. Patient and the physician global assessment score showed that 26 (74.3%) and 20 (57.14%) patients, respectively, had >50% pigment clearance. Conclusion: The melanin index, a simple non-invasive parameter is useful in assessing the treatment response more objectively. The 1064-nm Q-switched Nd-Yag laser offers good improvement in patients with nevus of Ota in darker skin types IV/V.
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Affiliation(s)
- Gomathy Sethuraman
- Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod K Sharma
- Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
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Fusade T, Lafaye S, Laubach HJ. Nevus of Ota in Dark Skin-An Uncommon but Treatable Entity. Lasers Surg Med 2011; 43:960-4. [PMID: 22127621 DOI: 10.1002/lsm.21121] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2011] [Indexed: 11/10/2022]
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