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Guo ZZ, Wang ZC, Wang D, Ge LL, Li YH, Gu YH, Wang W, Wei CJ, Gu B, Yao M, Dong JY, Li QF. Laser treatment for Cafe-au-lait Macules: a systematic review and meta-analysis. Eur J Med Res 2023; 28:185. [PMID: 37291616 DOI: 10.1186/s40001-023-01143-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/15/2023] [Indexed: 06/10/2023] Open
Abstract
Nowadays, laser is the mainstay treatment for cafe-au-lait macules (CALMs), but no systematic review has been published to demonstrate the overall efficacy and it's still controversial which type of laser is optimal. Thus, we conduct the meta-analysis to evaluate the effectiveness and side effects of various types of lasers in treating CALMs. Original articles reporting the efficacy and side effects for CALMs in laser treatment were identified in PubMed, EMBASE, and Web of Science from 1983 to April 11, 2023. Using R software and the 'meta' package, meta-analysis was conducted for clearance and recurrence for evaluation of efficacy. And the occurrence of hypopigmentation and hyperpigmentation rate was pooled for safety evaluation. We used RoB2 and ROBINS-I tools to assess the risks of bias in RCT studies and non-RCT studies, respectively. The Grading of Recommendations, Assessment, Development and Evaluation system was used to assess the quality of the evidence. Nineteen studies involving 991 patients were included, which had a very low to moderate quality of evidence. The pooled 75% clearance rate was 43.3% (95% CI 31.8-54.7%, I2 = 96%), 50% clearance rate was 75% (95% CI 62.2-85.9%, I2 = 89%) and the recurrence rate was 13% (95% CI 3.2-26.5%, I2 = 88%). The pooled hypopigmentation and hyperpigmentation rates were 1.2% (95% CI 0.3-2.1%, I2 = 0%) and 1.2% (95% CI 0.3-2%, I2 = 0%), respectively. Subgroup analysis revealed that QS-1064-nm Nd:YAG laser treatment not only achieved more than 75% clearance rate in 50.9% of patients (95% CI 26.9-74.4%, I2 = 90%) but also resulted in the lowest hypopigmentation and hyperpigmentation rate of 0.5% (95% CI 0.0-2.5%, I2 = 26%) and 0.4% (95% CI 0.0-2.5%, I2 = 0%). To draw a conclusion, the laser treatment could reach an overall clearance rate of 50% for 75% of the patients with CALMs, for 43.3% of the patients, the clearance rate could reach 75%. When looking at different wavelength subgroups, QS-1064-nm Nd:YAG laser exhibited the best treatment capability. Laser of all the wavelength subgroups presented acceptable safety regarding of the low occurrence of side effects, namely, hypopigmentation and hyperpigmentation.
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Affiliation(s)
- Zi-Zhen Guo
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China. gzzhen2016-@sjtu.edu.cn
| | - Zhi-Chao Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Dun Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
- Department of Burn and Plastic Surgery, West China Hospital of Sichuan University, No 37 Wainan Guoxue Road, Chengdu, 610041, China
| | - Ling-Ling Ge
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Yue-Hua Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Yi-Hui Gu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Wei Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Cheng-Jiang Wei
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Bin Gu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Min Yao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Ji-Ying Dong
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
| | - Qing-Feng Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
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Use of Reflectance Confocal Microscopy to Predict Treatment Efficacy in Café Au Lait Macules. Dermatol Surg 2021; 47:e71-e74. [PMID: 34328286 DOI: 10.1097/dss.0000000000002797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multiple lasers have been used for the treatment of café au lait macules (CALMs) with various results. Objective tools to predict therapeutic efficacy of CALMs treatment is lacking. OBJECTIVE To determine whether reflectance confocal microscopy (RCM) characteristics correlate with CALMs response to laser treatment. MATERIALS AND METHODS All CAMLs underwent RCM examination of length and density of dermal papillae followed by 3 sessions of Q-switched alexandrite laser (QSAL). A visual analog scale was used to assess clinical treatment efficacy. RESULTS Forty-three patients were included, 22 had CALMs with irregular borders and 21 with smooth borders. Café au lait macules with irregular border had shorter rete pegs and less papillae (p < .05) on RCM compared with smooth border CAMLs and responded better to QSAL treatment (2.32 vs 1.10). CONCLUSION Reflectance confocal microscopy measurement of length and density of papillae were inversely correlated with treatment response. Reflectance confocal microscopy may be a useful tool to predict CALMs response to laser treatment.
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Pun J, Zancanaro P, Widjajahakim R, Karch J, Vashi NA. Assessing the safety of the Q-switched 755-nm alexandrite laser in darker skin: A retrospective study. J Am Acad Dermatol 2021; 86:909-911. [PMID: 33753256 DOI: 10.1016/j.jaad.2021.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/02/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Jonathan Pun
- Department of Dermatology, Boston Medical Center, Boston, Massachusetts
| | - Pedro Zancanaro
- Department of Dermatology, Boston Medical Center, Boston, Massachusetts
| | | | - Jamie Karch
- Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Neelam A Vashi
- Department of Dermatology, Boston Medical Center, Boston, Massachusetts.
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Cen Q, Gu Y, Luo L, Shang Y, Rao Y, Zhu J, Han Y, Yu W, Liu Y, Wu X, Ying H, Ma G, Lin X. Comparative Effectiveness of 755-nm Picosecond Laser, 755- and 532-nm Nanosecond Lasers for Treatment of Café-au-Lait Macules (CALMs): A Randomized, Split-Lesion Clinical Trial. Lasers Surg Med 2020; 53:435-442. [PMID: 32896932 DOI: 10.1002/lsm.23316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Many types of lasers have been used to treat café-au-lait macules (CALMs) since the introduction of the selective photothermolysis theory. However, the efficacy and safety of picosecond lasers, compared with those of nanosecond lasers, have not been researched. To compare the efficacy and safety of 755 nm picosecond laser (PS-755 nm), Q-switched (QS) Alexandrite 755 nm nanosecond laser (QS-755 nm), and QS Nd:YAG 532 nm nanosecond laser (QS-532 nm) for treating CALMs. STUDY DESIGN/MATERIALS AND METHODS Forty-one patients received several treatments at 3-month intervals. Lesions were divided into two or three approximately equal parts, which were randomly treated with PS-755 nm, QS-755 nm, and QS-532 nm. The safety and efficacy of three lasers were determined based on blinded visual assessments and self-reports of patients three months after the comparative trial. RESULTS Visual assessment 3 months after the comparative trial revealed that there was no statistically significant difference among the sites treated by QS-755 nm (2.84 ± 1.11), QS-532 nm (2.63 ± 1.06), and PS-755 nm (2.74 ± 1.05) lasers. Five (26.32%) of 19 patients showed lesion recurrence. Adverse effects included acneiform miliaris, hypopigmentation, and hyperpigmentation, which were resolved within 12 months. Five (26.32%) of 19 patients who showed lesion recurrence 1-5 months after laser treatment had lightened or cleared at least 50% of the lesion. 46.67% of patients were satisfied or very satisfied with the outcome of the overall treatment. CONCLUSIONS PS-755 nm, QS-755 nm, and QS-532 nm laser treatments were equally effective in treating and improving CALMs. PS-755 nm caused fewer adverse effects. Individuals can react differently to different types of lasers. Patch tests should be conducted before the treatment. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Qingqing Cen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Yifei Gu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Lan Luo
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Ying Shang
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Yamin Rao
- Department of Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Jiafang Zhu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Yue Han
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Wenxin Yu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Ying Liu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Xianglei Wu
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Hanru Ying
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Gang Ma
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
| | - Xiaoxi Lin
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China.,Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, Shanghai, 200011, PR China
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Patel PD, Mohan GC, Bhattacharya T, Patel RA, Tsoukas M. Pediatric Laser Therapy in Pigmented Conditions. Am J Clin Dermatol 2019; 20:647-655. [PMID: 31134589 DOI: 10.1007/s40257-019-00449-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Advances in laser therapy have led to novel therapeutic approaches to common pediatric skin conditions. As a non-invasive alternative to surgical options, laser therapy is efficacious in treating a broad range of conditions, from vascular and pigmented lesions to tattoo and hair removal. This paper reviews the basic mechanics of laser therapy, its role in common pigmented pediatric dermatoses, and special considerations for this unique age group.
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Zhang B, Chu Y, Xu Z, Sun Y, Li L, Han X, Wang C, Wei L, Liu Y, Ma L. Treatment of Café-Au-Lait Spots Using Q-Switched Alexandrite Laser: Analysis of Clinical Characteristics of 471 Children in Mainland China. Lasers Surg Med 2019; 51:694-700. [PMID: 31129919 PMCID: PMC6771696 DOI: 10.1002/lsm.23097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2019] [Indexed: 12/14/2022]
Abstract
Background and Objectives Café‐au‐lait spots, also known as café‐au‐lait macules (CALMs), are a common pigmentary disorder. Although various laser modalities have been used to treat CALMs, the efficacy of laser treatment in children differs from that in adults. We investigated the efficacy, safety, and clinical factors of the treatment of CALMs using Q‐switched alexandrite laser (755 nm) therapy in children. Methods In total, 471 children with CALMs underwent Q‐switched alexandrite laser therapy at a treatment interval of 3–12 months. The safety and efficacy of the laser treatment were evaluated by reviewing clinical records and photographs before and after treatments. Results Of the 471 patients, 140 (29.72%) were cured completely, 124 (26.33%) showed substantial improvement, 110 (23.35%) showed improvement, and 97 (20.60%) showed no improvement after one to nine treatments. The overall treatment success rate was 79.41%, and the treatment efficacy was positively correlated with the number of laser treatments (rs = 0.26, P < 0.0001). Sex and the interval of laser treatments were also associated with significant differences in treatment outcomes (P < 0.05). No obvious adverse effects were observed. Multivariate logistic regression analysis showed that the number of treatments influenced the treatment efficacy (odds ratio, 2.130; 95% confidence interval, 1.561–2.908). Conclusions Q‐switched alexandrite laser (755 nm) therapy is safe and highly effective for CALMs in children, and the number of treatments affects the treatment efficacy. Lasers Surg. Med. © 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Bin Zhang
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China
| | - Yan Chu
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China
| | - Zigang Xu
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China
| | - Yujuan Sun
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China
| | - Li Li
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China
| | - Xiaofeng Han
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China
| | - Chen Wang
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China
| | - Li Wei
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China
| | - Yuanxiang Liu
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China
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7
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Lin Y, Liu H, Shi W, Wang H, Geng J, Guo X, Wang J, Zhang F. Preliminary experience of the Q‐switched 1064‐nm neodymium:yttrium aluminum garnet laser in the treatment of Café‐au‐lait macules. J Eur Acad Dermatol Venereol 2019; 33:e185-e186. [PMID: 30472738 DOI: 10.1111/jdv.15364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Y. Lin
- Shandong Provincial Hospital for Skin Diseases Shandong University Jinan Shandong China
| | - H.X. Liu
- Shandong Provincial Hospital for Skin Diseases Shandong University Jinan Shandong China
| | - W.H. Shi
- Shandong Provincial Hospital for Skin Diseases Shandong University Jinan Shandong China
| | - H.X. Wang
- Shandong Provincial Hospital for Skin Diseases Shandong University Jinan Shandong China
| | - J.H. Geng
- Shandong Provincial Hospital for Skin Diseases Shandong University Jinan Shandong China
| | - X. Guo
- Shandong Provincial Hospital for Skin Diseases Shandong University Jinan Shandong China
| | - J.L. Wang
- Shandong Provincial Hospital for Skin Diseases Shandong University Jinan Shandong China
| | - F.R. Zhang
- Shandong Provincial Hospital for Skin Diseases Shandong University Jinan Shandong China
- Shandong Provincial Key Lab for Dermatovenereology Jinan Shandong China
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8
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Evaluation of the safety and efficacy of the dual wavelength picosecond laser for the treatment of benign pigmented lesions in Asians. Lasers Surg Med 2018; 51:14-22. [DOI: 10.1002/lsm.23028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2018] [Indexed: 11/07/2022]
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9
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Baek JO, Park IJ, Lee KR, Ryu HR, Kim J, Lee S, Kim YR, Hur H. High-fluence 1064-nm Q-Switched Nd:YAG laser: Safe and effective treatment of café-au-lait macules in Asian patients. J Cosmet Dermatol 2018; 17:380-384. [DOI: 10.1111/jocd.12432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Jin Ok Baek
- Department of Dermatology; Gachon University, College of Medicine; Incheon Korea
| | | | - Kyung Real Lee
- SKINDA Dermatology Clinic/Korea Dermatology Research Institute (KDRI); Bundang Korea
| | - Ha Ryeong Ryu
- Department of Dermatology; Gachon University, College of Medicine; Incheon Korea
| | - Jeongsoo Kim
- Department of Dermatology; Gachon University, College of Medicine; Incheon Korea
| | - Seulki Lee
- Department of Dermatology; Gachon University, College of Medicine; Incheon Korea
| | - Yu Ri Kim
- Choice Dermatology Clinic; Pyeongchon Korea
| | - Hoon Hur
- Choice Dermatology Clinic; Pyeongchon Korea
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Belkin DA, Neckman JP, Jeon H, Friedman P, Geronemus RG. Response to Laser Treatment of Café au Lait Macules Based on Morphologic Features. JAMA Dermatol 2017; 153:1158-1161. [PMID: 28854299 DOI: 10.1001/jamadermatol.2017.2807] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Response to laser treatment for café au lait macules (CALMs) is inconsistent and difficult to predict. Objective To test the hypothesis that irregularly bordered CALMs of the "coast of Maine" subtype respond better to treatment than those of the smooth-bordered "coast of California" subtype. Design, Setting, and Participants This retrospective case series included patients from 2 multiple-clinician US practices treated from 2005 through 2016. All patients had a clinical diagnosis of CALM and were treated with a Q-switched or picosecond laser. A total of 51 consecutive patients were eligible, 6 of whom were excluded owing to ambiguous lesion subtype. Observers were blinded to final patient groupings. Exposures Treatment with 755-nm alexandrite picosecond laser, Q-switched ruby laser, Q-switched alexandrite laser, or Q-switched 1064-nm Nd:YAG laser. Main Outcomes and Measures Main outcome was grade in a visual analog scale (VAS) consisting of 4 levels of treatment response: poor (grade 1, 0%-25% improvement), fair (grade 2, 26%-50% improvement), good (grade 3, 51%-75% improvement), and excellent (grade 4, 76%-100% improvement). Results Forty-five patients were included in the series, 19 with smooth-bordered lesions and 26 with irregularly bordered lesions. Thirty-four (76%) of the participants were female; 33 (73%) were white; and the mean age at the time of laser treatment was 14.5 years (range, 0-44 years). Smooth-bordered lesions received a mean VAS score of 1.76, corresponding to a fair response on average (26%-50% pigmentary clearance). Irregularly bordered lesions received a mean VAS score of 3.67, corresponding to an excellent response on average (76%-100% clearance) (P < .001). Conclusions and Relevance CALMs with jagged or ill-defined borders of the coast of Maine subtype tend to respond well to laser treatment, whereas those with smooth and well-defined borders of the coast of California subtype tend to have poor response. Clinicians using Q-switched or picosecond lasers to treat CALMs can use morphologic characteristics to help predict response and more effectively manage patient expectations.
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Affiliation(s)
| | | | - Hana Jeon
- Laser & Skin Surgery Center of New York, New York
| | - Paul Friedman
- Laser & Skin Surgery Center of New York, New York.,Dermatology & Laser Surgery Center, Houston, Texas
| | - Roy G Geronemus
- Laser & Skin Surgery Center of New York, New York.,Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York
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Picosecond 532-nm neodymium-doped yttrium aluminium garnet laser—a novel and promising modality for the treatment of café-au-lait macules. Lasers Med Sci 2017; 33:693-697. [DOI: 10.1007/s10103-017-2373-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022]
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12
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Rho NK. Treatment of Café-au-lait Macules Using a Q-switched Laser Followed by Serial Fractional Thulium Laser Treatments. ACTA ACUST UNITED AC 2017. [DOI: 10.25289/ml.2017.6.1.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Nark-Kyoung Rho
- Leaders Aesthetic Laser and Cosmetic Surgery Center, Seoul, Korea
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13
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Balaraman B, Ravanfar-Jordan P, Friedman PM. Novel use of non-ablative fractional photothermolysis for café-au-lait macules in darker skin types. Lasers Surg Med 2016; 49:84-87. [DOI: 10.1002/lsm.22535] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2016] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Paul M. Friedman
- Dermatology and Laser Surgery Center; Houston Texas
- Department of Dermatology; University of Texas Houston Medical School; Houston Texas
- Department of Dermatology; Weill Cornell Medical College; Houston Methodist Hospital; Houston Texas
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14
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Chan JCY, Shek SYN, Kono T, Yeung CK, Chan HHL. A retrospective analysis on the management of pigmented lesions using a picosecond 755-nm alexandrite laser in Asians. Lasers Surg Med 2015; 48:23-9. [DOI: 10.1002/lsm.22443] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Johnny Chun-yin Chan
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Samantha Yee-nam Shek
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Taro Kono
- Department of Plastic Surgery; Tokai University; Kanagawa Japan
| | - Chi Keung Yeung
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
| | - Henry Hin-lee Chan
- Division of Dermatology; Department of Medicine; The University of Hong Kong; Hong Kong SAR China
- Wellman Center for Photomedicine; Massachusetts General Hospital; Boston Massachusetts
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15
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A low-fluence 1064-nm Q-switched neodymium-doped yttrium aluminium garnet laser for the treatment of café-au-lait macules. J Am Acad Dermatol 2015; 73:477-83. [DOI: 10.1016/j.jaad.2015.06.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 05/27/2015] [Accepted: 06/01/2015] [Indexed: 11/20/2022]
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