ABSTRACT
Verrucous epidermal nevus (VEN) is a skin disorder that commonly presents at birth; it is characterized by skin-colored to brown verrucous papules in a linear distribution following Blaschko's lines. Even though it is extremely rare, VEN has been associated with malignant transformation. VEN has been treated by different treatment modalities with varying and frustrating results. We introduce a new type of treatment. The fractional micro-plasma radio-frequency (RF) technology, which uses unipolar RF technology to provoke plasma spars, creating multiple controlled micro-perforations on the skin. Photodynamic therapy (PDT) is a type of technology for disease diagnosis and treatment, in which a photosensitizer gathers within the nidus and kills the diseased cells. In this report, we present a case of VEN that was successfully treated with fractional micro-plasma RF technology and PDT without side effects or complications; a follow-up was conducted after 24 months and no signs of recurrence were observed.
Subject(s)
Hyperpigmentation/radiotherapy , Lasers, Solid-State/therapeutic use , Nevus, Sebaceous of Jadassohn/radiotherapy , Warts/radiotherapy , Adolescent , Female , Humans , Hyperpigmentation/etiology , Nevus, Sebaceous of Jadassohn/complications , Patient Satisfaction , Treatment Outcome , Warts/complicationsABSTRACT
A 4-year-old female with a unilateral circumscribed choroidal hemangioma and secondary total exudative retinal detachment. A nasal skin scar-like lesion incised to confirm a histopathologic diagnosis of linear nevus sebaceous. Further imaging disclosed asymmetry of the lateral ventricle frontal horns, suggestive of the diagnosis of linear nevus sebaceous syndrome. The choroidal hemangioma was treated with I-125 episcleral brachytherapy (apical dose of 45 Gy). At 6 months post-radiation, the tumor showed regression with total resolution of exudative retinal detachment.
Subject(s)
Choroid Neoplasms/diagnosis , Hemangioma/diagnosis , Nevus, Sebaceous of Jadassohn/diagnosis , Brachytherapy , Child, Preschool , Choroid Neoplasms/radiotherapy , Female , Fluorescein Angiography , Hemangioma/radiotherapy , Humans , Iodine Radioisotopes/therapeutic use , Nevus, Sebaceous of Jadassohn/radiotherapy , Retinal Detachment/diagnosis , Retinal Detachment/physiopathology , Subretinal Fluid , Vision Disorders/diagnosis , Visual Acuity , Visual FieldsABSTRACT
BACKGROUND: A verrucous epidermal nevus (VEN) is a skin disorder that has been treated using different treatment modalities with varying results. Ablative lasers such as carbon dioxide laser (CO2) and erbium:yttrium-aluminum-garnet (Er:YAG) laser have been considered as the gold standard for the treatment of epidermal nevi. OBJECTIVE: To evaluate and compare the efficacy, postoperative wound healing and side effects of pulsed CO2 laser and Er:YAG laser for the treatment of verrucous epidermal nevi. MATERIALS AND METHODS: Twenty patients with localized VEN were randomly divided into two groups. Group 1 was administered CO2 laser and group 2 underwent Er:YAG laser treatment. A blinded physician evaluated the photographs and dermoscopic photomicrographs for the efficacy and possible side effects. All patients received one treatment session and were followed up over a 6-month period. RESULTS: Both lasers induced noticeable clinical improvement, but there were no significant differences between two lasers in treatment response, patient satisfaction, duration of erythema and side effects. The average time to re-epithelialization was 13.5 days with CO2 and 7.9 days with Er:YAG laser (p< .0005). No scarring was observed in Er:YAG laser group and no lesional recurrence was detected in CO2 laser group since treatment. CONCLUSION: Apart from re-epithelialization, both lasers showed equivalent outcomes with respect to treatment response, patient satisfaction, side effects and complications.