Treatment of neurofibromas with a carbon dioxide laser: a retrospective cross-sectional study of 106 patients.

BACKGROUND: Few studies have evaluated the efficacy of carbon dioxide (CO2) laser ablation for treating neurofibromatosis type 1 (NF1). OBJECTIVE: To evaluate laser treatment safety and patient satisfaction at the French National Referral Centre for Neurofibromatosis. METHODS: Retrospective survey with a specific questionnaire. The principal outcome measures included pain evaluation and assessments of treatment safety. RESULTS: We included 106 patients, 70% of whom had more than 50 neurofibromas. Laser treatment was performed mostly for aesthetic reasons, or due to pain, recurrent local trauma or familial influence, under a local anaesthetic, during outpatient visits. The mean pain score was 4.0 ± 2.7 during the administration of local anaesthesia, 2.4 ± 2.1 during laser treatment and <2 48 h after treatment in 56% of cases. The mean satisfaction score for the treatment was 4.6 ± 3.4 and was not associated with disease phenotype. CONCLUSIONS: CO2 laser treatment for NF could be considered more frequently and might help to decrease the social impact of the disease.

Nevus of Ota in dark skin--an uncommon but treatable entity.

BACKGROUND: Nevus of Ota can be effectively and safely treated since the arrival of q-switched lasers in dermatology. However, available literature is scarce regarding the treatment of Nevus of Ota in skin types darker than IV. OBJECTIVES: We report about four Fitzpatrick phototype V patients treated for Nevus of Ota with a q-switched Nd:YAG laser at 1,064 nm. METHODS: Four patients with Fitzpatrick phototype V were treated for Nevus of Ota with a q-switched Nd:YAG laser at 1,064 nm in a private practice setting. Pulse diameter for the treatments was 2 mm and pulses were applied typically in a non-overlapping fashion. Treatment energies ranged from 4.1 to 9.5 J/cm(2) . RESULTS: All four patients of this case series showed significant cosmetic improvement. Improvement ratings, based upon pre- and post-treatment photographs rated by blinded investigators, were in between 6 and 10 with a mean of 8.5 on a 10-point scale. Side effects were mostly short termed and typical for this laser technique. No post-inflammatory hyperpigmentation was observed however one case of permanent drop-like hypopigmentation was encountered. CONCLUSIONS: A 1,064 nm q-switched Nd:YAG laser treatment could be an effective and reasonably safe treatment for patients with Nevus of Ota and Fitzpatrick skin type V. Patients should be counselled before treatment regarding the risk of permanent hypopigmentation.