Successful Treatment of Riehl's Melanosis With Mid-Fluence Q-Switched Nd:YAG 1064-nm Laser.

BACKGROUND AND OBJECTIVES: Riehl's melanosis is a chronic acquired hyperpigmentation disorder that causes significant cosmetic problems for patients with this condition. Several treatment options, including low-fluence Q-switched Nd:YAG (QSNY) 1064-nm laser treatment, have been attempted with inconsistent results. We aimed to investigate the beneficial effect of mid-fluence QSNY 1064-nm laser in the treatment of Riehl's melanosis. STUDY DESIGN/MATERIALS AND METHODS: A retrospective review was conducted on patients repetitively treated with mid-fluence (3.5-5 J/cm2 with a spot size of 5 mm and a pulse rate of 10 Hz) QSNY 1064-nm laser. Twenty-one patients with Riehl's melanosis were involved. Clinical photographs, treatment parameters, and side effects were reviewed to assess the safety and efficacy of the modality. RESULTS: The mean age of the patients was 57.00 ±8.2 years, and there were 20 female patients and 1 male patient. The mean number of treatment sessions was 5.95 ± 3.6, and the mean interval between each session was 39.12 ± 13.4 days. After treatment, the mean melasma area and severity index score decreased from 12.53 ± 10.2 to 5.98 ± 5.3. At the final visit, 16 of the 21 (76.1%) patients were considered to have moderately or very much improved. No severe side effects were observed. CONCLUSIONS: Repetitive mid-fluence QSNY 1064-nm laser treatment may be an effective and safe optional modality for Riehl's melanosis. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

Postinflammatory hyperpigmentation associated with treatment of solar lentigines using a Q-Switched 532-nm Nd: YAG laser: a multicenter survey.

PURPOSE: To characterize the risk factors of Korean patients for postinflammatory hyperpigmentation (PIH) during treatment of solar lentigines using a Q-switched 532-nm Nd: YAG (QS 532 NY) laser. MATERIALS AND METHODS: The present retrospective multicenter study was conducted at the dermatology clinics of five tertiary hospitals in Korea. Between October 2007 and January 2013, 516 patients were enrolled and reviewed for clinical features and factors associated with PIH. RESULTS: The overall incidence of PIH was 20.3%. We demonstrated that patients with erythematous lentigines presented with PIH more frequently compared with those without erythematous lentigines. Among several coexisting conditions, facial diffuse dyschromia was significantly associated with PIH. Furthermore, PIH occurred more frequently in patients with invisible pores and velvety skin. However, age, sex, Fitzpatrick skin's phototype and season of treatment showed little association with PIH. CONCLUSIONS: When a QS 532 NY laser is used to treat individuals with erythematous lentigines, invisible pores and velvety skin, and facial diffuse dyschromia, clinicians should be cautious and consider preventive measures.

Low-pulse energy Q-switched Nd:YAG laser treatment for hair-dye-induced Riehl's melanosis.

Riehl's melanosis, a form of dermatitis characterized by reticulate pigmentation, typically presents as a gray-brown to black hyperpigmentation on the face and neck. Among the various etiologic factors suggested, photoallergic reaction and pigmented contact dermatitis resulting from exposure to drugs, coal tar dyes, optical whitener, or other ingredients found in cosmetics are believed to be the major contributing factors in this disease. The histopathological features of Riehl's melanosis mainly consist of pigmentary incontinence along with infiltration of numerous dermal melanophages and lymphohistiocytes.1,2 Additionally, notable clinical improvements in the treatment of this condition have been reported for intense pulsed light (IPL) therapy, in comparison to long-term topical application of bleaching agents.2 Here, we report the cases of two Asian patients treated with a low-pulse energy 1,064-nm Q-switched (QS) Nd:YAG laser for hair dye-induced Riehl's melanosis on the face and neck. In conclusion, we observed that Riehl's melanosis on the face and neck was effectively and safely treated with a low-pulse energy 1,064-nm QS Nd:YAG laser. We suggest that this method can be used in Asian patients with Riehl's melanosis at risk of postinflammatory hyperpigmentation from excessive light or laser energy delivery.

The 308-nm excimer laser: a promising device for the treatment of childhood vitiligo.

BACKGROUND: Numerous modalities have been used to treat vitiligo in children. Up to now, phototherapy and topical corticosteroids are the most commonly used treatments for adult vitiligo but studies evaluating the efficacy of these treatments in the pediatric population remain insufficient. OBJECTIVE: This study was a retrospective review to evaluate the efficacy and safety of 308-nm excimer laser treatment in 30 childhood vitiligo patients. METHODS: Thirty vitiligo patients with 40 vitiligo patches were evaluated after the cessation of 308-nm excimer laser treatment. RESULTS: Seventeen patients (56.7%) with 20 patches (50%) achieved an acceptable degree (>50%) of repigmentation at the end of the treatment, with five patches (12.5%) showing >75% of repigmentation. The treatment response showed anatomical preferences, favoring the face, neck and trunk. However, the treatment response did not correlate to the cumulative dose or duration of treatment. Side effects occurred in nine patients, but were transient and minimal. CONCLUSION: The results of this study shows that the 308-nm excimer laser can be an effective and promising device for the treatment of various vitiligo types, other than generalized, in childhood.

Vitiligo following intense pulsed light treatment.

Vitiligo is an acquired depigmenting disorder characterized by the progressive loss of melanocytes from the epidermis and epidermal appendages, which results in milky-white macular lesions. Various factors are suspected to affect the induction and progression of vitiligo such as emotional shock, sunburn, pregnancy, physical illness and trauma. The intense pulsed light (IPL) device which mostly affects redness and dyspigmentation has a broad spectrum of emissions of white light with wavelengths between approximately 515 and 1200 nm. Adverse effects such as purpura and pigmentary changes are known to be rare. We present a 41-year-old woman who developed multiple round, hypopigmented macules on both the cheek and mandibular area following the treatment with IPL for lentigines and dyspigmentation. Based on biopsy and Wood's lamp examination, diagnosis as vitiligo was made. She was treated with a 308-nm excimer laser. After 3 months of treatment, almost complete repigmentation was seen but another coin-sized hypopigmented patch was noted after 5 months later. Herein, we report a case of vitiligo which developed after IPL treatment. This is the first case to be reported which vitiligo developed after IPL treatment. Therefore, dermatologists should be aware of unsighted vitiligo lesion before IPL treatment.

Effects of various parameters of the 1064 nm Nd:YAG laser for the treatment of enlarged facial pores.

BACKGROUND: A variety of treatment modalities have been used to reduce the size of enlarged facial pores without obvious success. OBJECTIVES: To assess and compare the effects of various parameters of a 1064 nm Nd:YAG laser in the treatment of enlarged facial pores. METHODS: This was a prospective intra-individual left-right comparative study. A total of 40 individuals with enlarged facial pores were recruited for this study. Ten individuals were respectively treated on one half of the face with a quasi long-pulsed 1064 nm Nd:YAG laser (method 1), a Q-switched 1064 nm Nd:YAG laser (method 2), both quasi long-pulsed and Q-switched 1064 nm Nd:YAG lasers without carbon-suspended lotion (method 3), and both quasi long-pulsed and Q-switched 1064 nm Nd:YAG lasers with carbon-suspended lotion (method 4). The other half of the face was left untreated as a control. Five laser sessions were performed with a 3-week interval. The pore sizes were measured using an image analysis program and the sebum level was measured with a Sebumeter before and after the treatments. RESULTS: The pore size and sebum level decreased in all four methods on the treated side compared to the control (p < 0.05). CONCLUSIONS: Treatment with a 1064 nm Nd:YAG laser is an effective method for reducing pore size and sebum level.