4990
Amira Rashad Youssef
Glinical and Histopathological Evaluation of the Efficacy of Different Laser Gombinations in Treatment of Becker,s Melanosis
Becker'q..nevgs, laser, hair removal, Long pulsed Nd:YAG, Q - switched Nd:YAG, q-H,t itcneil K-TP.
Background: Becker's nevus (BN) can represent a distressing cosmetic [unOiIup and a challenging issue regarding treatment. Its etiopathogenesis is ,of"o*". BN is consideredan organoid hamartoma of ecto-mesodermal tissues, upp*ting sporadically by cutaneous mosaicism; however, autosomal dominant ilheritan-ce with incomplete penetrance has been documented. Therapeutic intervention for BN is pii*uriiy for cosmetic reasons because of location, color and size or other clinical features. Before the advent of laser treatment option for pigmented lesions, treatments were limited to surgical excision, dermabrasion' ilJctrodesiccation, chemical peeling or chemical bleaching as hydroquinone' These treatments often resulted in scarring, pigmentary changes and/or cutaneous infections. over the past decade, the development of pigment-specific and hair removal lasers has piovided a therapeutic alternative for many pigmented and hrt" lesions. The cunent work was conducted to detect gI 1.11q the following laser types : long pulsed Nd-YAG(1064), Q-switched Nd:YAG (l064nm) and QswitciedKTP(53nm). Each type was used alone and in combination' Patients and methods: Twenty-seven patients (14 female and 13 males) with BN (skin types III- IV). BN was divided into two parts: control part and treated part. The tieated part was fuither divided into 3 similar areas: A, B and C' Area i received long pulsed Nd:YAG (1064 nm) , area B partly received Q-switched Nd: YAG(I064nm) and Q-switched KTP(532nm) and area C received the three types of taser combined. Each patient received three treatment sessions with two months interval. Clinical evaluation and follow up were done every four weeks' Histological evaluation was done for all patients by taking a 4 mm punch biopsy at baseline and 3 months after treatment in each treated area (A, B, C)' Results: All patients achieved significant improvement regarding hair reductionin Area A (p value < 0.001). However, there was no color improvemenl Area B; 4 out of 24patients (16JYo) achieved marked pigment clearance (p value 0.004)' Area C; 9 out of i+ patients (37.5%) achieved marked pigment clearance (P value :0.001). Histopathology showed'reduction in both basal pigmentation and melanophages in u..u C *oi. than area B. While area A showed no decrease in basal pigmentation or melanophages. Conclusion: BN is a therapeutically challenging pigmentery disordei. Combined laser treatment (Q-switched KTP and Q-iwii.tt.O Nd:YAG and long pulsed Nd:YAG) might offer an effective therapeutic modality for such condition.
2015
M.Sc
Cairo
Medicine