Carbon dioxide laser treatment of epidermal nevi: response and long-term follow-up.

BACKGROUND AND OBJECTIVES: Epidermal nevi, which are benign skin growths, have been treated using a range of approaches, with varying results. Topical treatments are ineffective and, while surgical excision is a more definitive treatment, it causes scar formation. In recent decades, epidermal nevi have been treated with various types of laser therapy. We describe our experience with the use of carbon dioxide (CO(2)) laser therapy to treat epidermal nevi and inflammatory linear verrucous epidermal nevi (ILVEN). PATIENTS AND METHODS: Twenty patients (15 with epidermal nevi and 5 with ILVEN) underwent CO(2) laser treatment at our hospital between 2002 and 2010. RESULTS: Response was good (>50% reduction in lesion size) in 50% of cases and excellent (>75% reduction) in 30%. A greater resistance to treatment was observed in patients with ILVEN (only 40% had a good response). Long-term follow-up (at least 18 months) showed a recurrence rate of 30%. The side effects were hypopigmentation (25% of patients) and scarring (20%). CONCLUSIONS: We consider CO(2) laser therapy to be the treatment of choice for epidermal nevi as it is well tolerated and has proven to be safe and effective in the long term. While the response in patients with ILVEN was limited, CO(2) laser therapy might be a good option for selected cases or for palliative treatment since no other treatments have yet proven effective in this setting.

Carbon Dioxide Laser Treatment of Epidermal Nevi: Response and Long-Term Follow-Up. / Nevos epidérmicos tratados con láser de CO(2): respuesta y seguimiento a largo plazo.

BACKGROUND AND OBJECTIVES: Epidermal nevi, which are benign skin growths, have been treated using a range of approaches, with varying results. Topical treatments are ineffective and, while surgical excision is a more definitive treatment, it causes scar formation. In recent decades, epidermal nevi have been treated with various types of laser therapy. We describe our experience with the use of carbon dioxide (CO(2)) laser therapy to treat epidermal nevi and inflammatory linear verrucous epidermal nevi (ILVEN). PATIENTS AND METHODS: Twenty patients (15 with epidermal nevi and 5 with ILVEN) underwent CO(2) laser treatment at our hospital between 2002 and 2010. RESULTS: Response was good (>50% reduction in lesion size) in 50% of cases and excellent (>75% reduction) in 30%. A greater resistance to treatment was observed in patients with ILVEN (only 40% had a good response). Long-term follow-up (at least 18 months) showed a recurrence rate of 30%. The side effects were hypopigmentation (25% of patients) and scarring (20%). CONCLUSIONS: We consider CO(2) laser therapy to be the treatment of choice for epidermal nevi as it is well tolerated and has proven to be safe and effective in the long term. While the response in patients with ILVEN was limited, CO(2) laser therapy might be a good option for selected cases or for palliative treatment since no other treatments have yet proven effective in this setting.

Dermatofibromas treated with pulsed dye laser: Clinical and dermoscopic outcomes.

Dermatofibroma (DF), a common benign skin tumour, sometimes requires treatment either because of cosmetic concern or for associated symptoms. However, no effective treatment with optimal cosmetic outcomes has been reported. An effective and safe therapeutic option could be treatment with pulsed dye laser (PDL). Twenty-two DFs in 15 patients were treated with PDL at 595-nm wavelength, using a spot size of 7 mm, a pulse duration of 2 ms and a fluence of 11 J/cm(2) with 2 or 3 stacked pulses. Clinical and dermoscopic photographs were taken before and after therapy. Global clinical improvement was higher than 50% in 12 lesions. Patient satisfaction assessment showed 73% of patients as satisfied or very satisfied. All lesions showed changes from the previous dermoscopic pattern. We consider that PDL could be a safe, palliative treatment as it is well accepted by patients and has a better cosmetic outcome than surgical excision.