Analysis of 28 Chinese Cases of Bilateral Nevus of Ota and Therapeutic Results With the Q-Switched Alexandrite Laser.

BACKGROUND: Nevus of Ota is a dermal melanocytic lesion that presents as bluish hyperpigmentation along the first or second branch of the trigeminal nerve. It is common in Asians. However, bilateral involvement is rare. There has been no detailed report on bilateral involvement in Chinese people. OBJECTIVE: To analyze the clinical data on bilateral nevus of Ota in Chinese patients and determine the efficacy of pulsed q-switched alexandrite laser treatment. METHODS: Twenty-eight cases of bilateral nevus of Ota were diagnosed by clinical appearance, and detailed clinical data were collected. A q-switched alexandrite laser was used for treatment. RESULTS: The incidence of bilateral nevus of Ota was 1.4% (28 of 1985). More than 3 regions were involved in most patients (96.4%), and symmetrical lesions were observed in approximately 60% of cases (17 of 28). The lesion was seen at or soon after birth in 15 patients (53.6%); two-thirds of these patients (10 of 15) had ocular or mucosal involvement. The therapeutic results were excellent or good in 17 cases; the group that received more than 3 treatments and age of starting treatment being less than 6 years had better therapeutic results. CONCLUSION: The pulsed q-switched alexandrite laser is an effective treatment, and earlier intervention with more sessions achieves better results.

Melasma and aspects of pigmentary disorders in Asians.

Pigmentary changes in Asians are larger problems and more important features of aging than wrinkles. Melasma is a commonly observed epidermal hypermelanosis of the face in Asians. The altered dermal structures and impaired basement membrane are thought to have an influence on the development of epidermal hyperpigmentation of melasma. Dermal hyperpigmentary diseases are particularly common in Asians. Acquired bilateral melanosis of the neck is a characteristic dermal melanotic condition primarily of the neck in peri-menopausal women. It is characterized by marked accumulation of dermal pigment with perivascular lymphocytic infiltration. The cases seem to represent a continuum of Riehl's melanosis. Subclinical injury or inflammation may play a role as possible causative factors for the development of the pigmentation.

A population-based study of acquired bilateral nevus-of-Ota-like macules in Shanghai, China.

Acquired bilateral nevus-of-Ota-like macule (ABNOM) is a common skin dyspigmentation in Asian females. Although its clinical characteristics are well defined, its epidemiology and pathogenesis remain unclear. A large population-based cross-sectional study was conducted to determine the prevalence and risk factors of ABNOM. A total of 8,680 subjects (ages ranging from newborn to 99 years old; 54% female) were selected from urban areas in Shanghai, China, using a multistage sampling method. All participants (response rate=97%) were interviewed and examined for the presence of various pigmentary disorders by board-certified dermatologists. ABNOM was found in 2.5% of the study population (0.5% of males and 4.2% of females), and 90% of cases observed were female. In females, prevalence rose after the age of 15 years and sharply declined after the age of 50 years, with nearly half of the cases observed within ages 45-55 years (prevalence=8.5%). Age, contraceptive use, and sun exposure were independently associated with ABNOM. Women with ABNOM were less likely to have facial nevomelanocytic nevi and seborrheic keratoses. These findings indicate that sex hormone alteration and UV exposure may independently have an important role on the pathogenesis of ABNOM.

Clinical features of Ota's naevus in Koreans and its treatment with Q-switched alexandrite laser.

Ota's naevus is a fairly common pigmentary disorder in Asians. Recently, encouraging results in the treatment of Ota's naevus have been obtained, but most of these concerned the white skins of Caucasian patients. Our purpose was to examine the clinical features of Ota's naevus in Koreans and to assess the clinical outcomes and histological changes induced by a Q-switched alexandrite laser at 755 nm. Eighty-seven Koreans with Ota's naevus were studied; the peak age of onset was during the first decade and adolescence. The infraorbital area was the most frequent site and black or dark brown colours predominated. Improvements were achieved in 52 patients (77%). Better results were obtained in unilateral lesions and patients who received a greater number of treatments. Mild hyperpigmentation after treatment was noticed in 14 patients and mild hypopigmentation in eight patients. However, all of these were reversed in time. Hypertrophic scarring or secondary infection did not occur. The histology of laser-irradiated lesions showed selective thermal damage of melanocytes in the upper dermis and the elimination of upper dermal pigmentation. Our clinical data demonstrate the usefulness of the Q-switched alexandrite laser for the treatment of Ota's naevus in brown skin.

Treatment of Hori's nevus with the Q-switched Nd:YAG laser.

BACKGROUND: Hori's nevus is an acquired pigmented lesion involving bilateral blue-brown facial macules. There has been a dearth of reported treatment modalities for this condition. OBJECTIVE: The purpose of this study was to evaluate the efficacy of the Q-switched Nd:YAG laser for the treatment of Hori's nevus. METHODS: The Q-switched Nd:YAG laser was used to treat Hori's nevus in 66 Asian patients. Patients were treated up to seven times. The follow-up time after the final treatment ranged from 3 to 44 months. RESULTS: Twenty six percent of patients showed good to excellent clearing after one to two treatments. Fifty percent of patients who underwent more than two treatments received good to excellent results. CONCLUSION: The Q-switched Nd:YAG laser can be used to treat Hori's nevus. Results are not as good as those seen with nevus of Ota.

Q-Switched ruby laser therapy of acquired bilateral nevus of Ota-like macules.

BACKGROUND: Acquired bilateral nevus of Ota-like macules (ABNLM), also called nevus fuscoceruleus zygomaticus or nevus of Hori, is a relatively common disease in Asia. It is refractory to all medical treatment. OBJECTIVE: To present the first report on the use of Q-switched ruby laser to treat ABNLM. METHODS: One hundred and forty female patients, ages 19-62 years (mean 39 years), were included in the study. The laser fluence employed was 7-10 J/cm2, at a repetition rate of 1 Hz, and with a spot size of 2-4 mm. The number of treatment sessions ranged from 1 to 6 (mean 2.3). RESULTS: Nine patients were lost to follow-up before complete clearance of the lesions, while in the remaining 131 patients complete clearance was obtained. The only complication was a long-term hypopigmentation, observed in three patients. There was no recurrence at 6 months- 4.3 years (mean 2.5 years) of follow-up. CONCLUSION: Q-switched ruby laser is an effective and less invasive tool to eradicate ABNLM.

Choroidal melanoma with oculodermal melanocytosis in Hispanic patients.

PURPOSE: To describe three Hispanic patients with oculodermal melanocytosis and uveal melanoma. METHOD: Case series. RESULTS: Three Hispanic patients with oculodermal melanocytosis and uveal melanoma underwent enucleation. The diagnosis of choroidal melanoma was confirmed by histopathologic examination. CONCLUSION: In the Hispanic population, uveal melanoma can occur in the presence of oculodermal melanocytosis.

Malignant melanoma in a Hispanic male with nevus of Ota.

Nevus of Ota is uncommon in the non-Oriental population. We report a case of malignant melanoma with metastasis to the genitourinary tract in a Hispanic male with nevus of Ota. Thirty-six prior cases of nevus of Ota with malignant melanoma reported in the English language are reviewed. Sixty-eight percent were women; 76% were Caucasians. Metastatic disease was reported in 16%. Three patients had liver metastases. Our case was the first involving the genitourinary tract. All but one patient with metastatic disease died within 1 month of presentation. Despite the increased frequency of nevus of Ota in the Japanese, only 4 cases of malignant melanoma have been reported. Nevus of Ota would appear to be a risk factor for developing malignant melanoma in the Caucasian population.