Picosecond laser treatment for drug‐induced melanonychia

Treatment of pigmentary disorders using picosecond laser in Asian patients: A meta-analysis and systematic review

There were many studies evaluating the effect of picosecond (PS) lasers, but no meta-analysis examined the effects of PS laser in the treatment of pigmentary disorders in Asians. The aim of this article was to review the before-after effect of PS laser in Asians for the treatment of pigmentary disorders. PubMed, Embase, and Cochrane library were searched for articles published up to May 2020. The evaluations were summarized into a 4-point scale that ranged from <25% (poor), 25%-50% (fair), 50%-75% (good), and 75%-100% (excellent). Effect sizes (ESs) were calculated according to laser wavelengths and lesion types. There were two randomized controlled trials, three single-arm trials, and three case series, with 200 patients. At 3 months after treatment, of all included patients, 3% (95%CI: 1%-6%) were evaluated as poor or worse, 9% (95%CI: 2%-21%) as fair, 29% (95%CI: 12%-50%) as good, and 56% (95%CI: 28%-83%) as excellent. The 532 and 1064, and 755 nm PS lasers had similar ESs across all four response groups. This meta-analysis suggested that 56% of Asian patients who underwent PS laser for the treatment of pigmentary disorders were evaluated as "excellent" about the pigment clearance by a dermatologist at least 3 months after treatment.

A Systematic Review of Picosecond Laser in Dermatology: Evidence and Recommendations

BACKGROUND AND OBJECTIVES

The use of picosecond laser in dermatology was originally focused on optimizing the removal of unwanted tattoos. Subsequent advances in this technology have broadened its clinical indications to include treatment of benign pigmented lesions, photodamage, melasma, and scar revision. In this systematic review, evidence-based recommendations are developed for the use of picosecond laser in dermatology.

STUDY DESIGN/MATERIALS AND METHODS

A comprehensive search of the English language literature was performed up to and including November 2019. Relevant citations were individually evaluated, synthesized, and categorized based on the Level of Evidence. With the addition of the authors' combined clinical experience, clinical recommendations were developed.

RESULTS

After application of inclusion and exclusion criteria, a total of 77 unique studies were evaluated. Treatment of benign pigmented lesions was associated with level I-IV evidence; rejuvenation was associated with level II evidence; melasma was associated with level II evidence; scar revision was associated with level II-III evidence; tattoo removal was associated with level I evidence.

CONCLUSION

Picosecond laser is a safe and effective treatment modality for an increasing range of dermatologic indications. Further development of this technology is warranted. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.