Picosecond alexandrite laser treatment of nevus of Ota in children.

BACKGROUND: The picosecond alexandrite laser has been safely and effectively used to treat the nevus of Ota in adults. However, limited data are available for children. OBJECTIVE: To investigate the efficacy, safety, and correlative influencing factors of a 755nm picosecond alexandrite laser in the treatment of nevus of Ota in children. METHODS: We retrospectively analyzed Chinese children with nevus of Ota who received a 755nm picosecond alexandrite laser treatment in a tertiary dermatological hospital. RESULT: A total of 305 pediatric patients received an average of two treatments achieving an average of 79% pigment clearance. After the first treatment, 22 patients achieved complete clearance (95%-100%), and 72 patients achieved excellent response (75%-94%), with an average initial efficacy of 63% lesion clearance. Treatment at an early age achieved better initial efficacy (0- to 12-month group >1- to 6-year group, 6- to 12-year group). And 0- to 12-month group achieved better final efficacy. More treatment sessions also increased the final efficacy. Both initial efficacy and final efficacy were better when treating a darker lesion. The incidence of complications was 12.1%, with 10.8% being post-inflammatory hyperpigmentation and 1.3% being hypopigmentation. The rate of recurrence was 6.6%. LIMITATION: Retrospective study. CONCLUSION: A 755nm picosecond alexandrite laser is safe and effective in treating nevus of Ota in children. Younger to initiate treatment, darker lesions, and more treatments are positively associated with better pigmentation clearance.

Exploring the potential of intradermal platelet-rich plasma in treating acquired bilateral nevus of Ota-like macule (Hori's nevus): A pilot study.

BACKGROUND: Hori's nevus is a common and challenging dermatological condition, often complicated by post-inflammatory hyperpigmentation following treatment. Platelet-rich plasma (PRP) has demonstrated efficacy in the treatment of hyperpigmentation disorders such as melasma and periorbital darkening. Given the benefits and minimally invasive nature of PRP treatments, exploring its application in managing Hori's nevus through further investigation is worthwhile. AIMS: To evaluate the safety and effectiveness of intradermal PRP therapy for the treatment of Hori's nevus. METHODS: Ten female patients received bilateral intradermal PRP injections every 2 weeks for a total of four treatments. The modified dermal pigmentation and severity index (mDPASI), mean melanin index (MI), brightening score, patient self-assessment, and clinical photographs were evaluated at 2, 4, 8, and 12 weeks post-treatment. Adverse events were also recorded to determine treatment safety. RESULTS: At 12 weeks post-treatment, mDPASI decreased 38.86%, from 0.929 ± 0.617 to 0.568 ± 0.415 (p < 0.05). The mean melanin index decreased 12.75%, from 208.650 ± 26.319 to 182.052 ± 17.028 (p < 0.05). In addition, the mean brightness score evaluated by two experts was 1.4, indicating 25-50% improvement. At the end of the study, 50% of the patients reported 50-75% improvement. Side effects included pain, mild edema, and bruising, which resolved spontaneously within 3 days. No serious side effects were found. CONCLUSION: Our results suggest that intradermal PRP therapy may be a safe and effective alternative for the treatment of Hori's nevus and can complement conventional interventions. However, further research with a larger sample size, control groups, and longer follow-up is needed to confirm these findings.

A retrospective study of 1064-nm Q-switched Nd:YAG laser therapy for acquired bilateral nevus of Ota-like macules.

BACKGROUND: The therapeutic efficacy of laser treatments for acquired bilateral nevus of Ota-like macules (ABNOM) varies among studies, and few studies have evaluated the factors affecting therapeutic effects. AIMS: To evaluate the efficacy and safety of 1064-nm Q-switched Nd:YAG laser (QSNYL) therapy for ABNOM and to identify the factors influencing the outcome. METHODS: A total of 110 patients with ABNOM were retrospectively evaluated and received two-to-nine treatment sessions. The effects of different factors on the therapeutic effect were analyzed on the basis of the number of treatments, age at first treatment, skin type, lesion color, affected area, number of lesion sites, and presence of concomitant melasma. RESULTS: The curative effect was positively correlated with the treatment time and negatively correlated with the increasing age at first treatment (p < 0.05). The curative effect was better in patients with skin type III than those with type IV ( p < 0.05) and in patients with a lesion area of less than 10 cm2 than those with a larger affected area (p < 0.05). Additionally, the treatment effect was poorer in patients with concomitant melasma (p < 0.05). The treatment effect was not significantly correlated with the lesion color or number of affected sites (p > 0.05). Eleven patients (10%) developed postinflammatory hyperpigmentation (PIH). CONCLUSIONS: Early and repeated QSNYL therapy achieved satisfactory results for ABNOM. The risk of PIH after laser treatment is highest among patients with older age, darker lesion color, and darker skin color. For patients with ABNOM with concurrent melasma, low-energy laser therapy is recommended to reduce the risk of melasma aggravation.

Prospective comparison study of a 550 picosecond 755 nm laser vs a 50 ns 755 nm laser in the treatment of nevus of Ota.

Since the introduction of selective photothermolysis, Q-switched nanosecond lasers have been used for the treatment of dermal pigmented lesions. Over the past several years, picosecond lasers have been introduced to the cosmetic community. We recently performed a study comparing a 550 picosecond 755 nm laser versus a 50 ns 755 nm laser, with the purpose of evaluating the clinical efficacy and complications of each laser when treating nevus of Ota. Ten Asian patients with nevus of Ota were enrolled in the study. Each lesion was split into 2 parts, and patients were treated with a 755 nm picosecond laser (PSL) and a 755 nm nanosecond laser (NSL). The clinical endpoint for fluence choice was immediate whitening (PSL: 2.33 ~ 3.36 J/cm2, NSL: 5.5 ~ 7 J/cm2) of the treated area. The pulse duration was fixed at 550 picoseconds (PSL) and 50 ns (NSL). The spot size of each laser was 2.5-3 mm. Laser treatments were performed until excellent clinical improvement was observed. Patients were examined 1 week after the first treatment, at each follow-up visit, and 6 months after the last laser treatment. The average number of treatment sessions to achieve excellent clinical improvement was 4.2 treatments using PSL and 5.4 treatments using NSL. One case of hyperpigmentation and one case of hypopigmentation were observed in the NSL treatment group. There were no complications in the PSL treatment group. The 755 nm 550 picosecond laser is significantly more effective than the 755 nm 50 ns laser in the treatment of nevus of Ota. The PSL treatment group also had minimum side effects.

Treatment of Nevus of Ota in Black patients with the 1064 nm QS or picosecond laser and nonablative fractional photothermolysis.

OBJECTIVES: Nevus of Ota is a benign melanocytic lesion that presents as a unilateral blue gray to brown facial patch favoring the distribution of the first two branches of the trigeminal nerve. Incidence is highest in Asian and Black populations, however, the overwhelming majority of studies are limited to diagnosis and treatment in Asian patients. We herein present 10 Black patients with Fitzpatrick skin types (FST) V and VI who underwent laser treatment for Nevus of Ota. METHODS: We performed a retrospective review of Black patients presenting with Nevus of Ota. Race was self-designated by all patients and documented in the medical record at the time of initial consultation. Primary outcomes were based on improvement using before and after photographs which were graded by three independent board-certified dermatologists using a 5-point visual analog scale. RESULTS: Ten FST V or VI patients with an age range of 9 months to 45 years were treated for Nevus of Ota. All patients were treated with the 1064 nm Q-switched neodymium doped yttrium aluminum garnet (QS Nd:YAG) and on average received 4.7 treatments at 2-10 month intervals. Fluence ranged from 1.8 to 2.3 J/cm2 , and total pulse count ranged from 510.9 to 776.6. 2/10 patients were additionally treated with 1550 nm nonablative fractional resurfacing (NAFR), and 1/10 patients underwent combination therapy with both NAFR and 1064 nm picosecond laser therapy. Overall, patients saw a mean improvement of 51%-75% at follow-up 5-254 weeks (mean 51.5 weeks) after treatment. Three patients experienced mild guttate hypopigmentation in treated areas. No other long-term adverse events were encountered. CONCLUSION: 1064 nm QS Nd:YAG laser therapy is a safe and efficacious treatment for Nevus of Ota in patients with FST V and VI. When patient improvement plateaus, combining therapy with 1550 nm NAFR or transitioning to 1064 nm picosecond laser may be of benefit. Patients should be counseled on the risk of guttate hypopigmentation. This is the largest case series to date of Black patients with Nevus of Ota, highlighting the need for further investigation to determine optimal device settings and treatment parameters for this population.

Aiming to personalized laser therapy for nevus of Ota: melanin distribution dependent parameter optimization.

Aiming to the personalized laser therapy of nevus of Ota (NO), a local thermal non-equilibrium model was employed to optimize laser wavelength, pulse duration, and energy density under different melanin depth and volume fraction. According to our simulation, the optimal pulse duration is between 15 and 150 ns to limit heat transfer inside the hyperplastic melanin, and 50 ns is recommended to decrease the energy absorption by normal melanin in epidermis. Correlations of the minimum and the maximum energy densities are proposed with respect to melanin depth and volume fraction for the 755-nm and 1064-nm lasers. For the same NO type, the therapy window of the 755-nm laser is larger than that of 1064-nm. For NO with shallow depth or low volume fraction, the 755-nm laser is recommended to make the treatment more stable owing to its lager therapy window. For deeper depth or higher volume fraction, the 1064-nm laser is recommended to avoid thermal damage of epidermis. Through comparison with clinical data, the optimized laser parameters are proved practicable since high cure rate can be achieved when energy density falls into the range of predicted therapy window. With developing of non-invasive measurement technology of melanin content and distribution, personalized treatment of NO maybe possible in the near future.

Nevus of Ota on the auricle successfully treated with Q-switched ruby laser.

Nevus of Ota is a dermal melanocytosis that consists of blue-brown spots, patches and plaques along the distribution of the first and second branches of trigeminal nerve. The efficacy of Q-switched ruby laser treatment against nevus of Ota on dark skin has not been described. The present case, a 2-month-old Indonesian girl, showed rare auricular involvement. Because ear has complicated steric structure, whose skin is sensitive and thin, pain and inflammatory reaction are inevitable. We discussed the difficulty of laser treatments on auricular lesions.

Efficacy and safety of 755 nm Q-switched Alexandrite Laser for Hori's nevus: a retrospective analysis of 482 Chinese women.

To evaluate the efficacy and safety of 755 nm Q-Switched alexandrite laser for Hori's nevus in a large cohort of Chinese women. We retrospectively analyzed the efficacy and safety of 755 nm Q-Switched alexandrite laser for Hori's nevus. Reduction in pigment was evaluated using a 4-score method. A total of 482 patients, aged 16 to 52 years, were included in this analysis. Patients were treated with 755 nm Q-Switched alexandrite laser at fluence levels of 5-8 J/cm2 for 2-4 treatment sessions. Following the treatments, 53% of patients showed over 75% reductions in pigment while 50-75% reductions in pigment were observed in 28% of patients. The rest displayed less than 50% improvements. Efficacy was positively correlated with the number of treatment sessions (p < 0.0001). Adverse reactions were temporary, mild erythema, and edema. A small portion of patients (15%) had hyperpigmentation, which disappeared within 2-6 months. 755 nm Q-Switched alexandrite laser is safe and has moderate benefits for Hori's nevus. Because its efficacy is positively correlated with the number of treatment sessions, increase in treatment sessions possibly could achieve a better outcome.

Efficacy evaluation and treatment parameter optimization for laser surgery of Ota's nevus based on an advanced non-equilibrium bio-tissue heat transfer model.

This study was performed to better understand the laser-tissue interaction mechanism and optimize the laser wavelength and pulse duration for the laser treatment of Ota's nevus, thereby providing the precise theoretical guidance for clinician to improve the therapeutic effect. A non-equilibrium bio-tissue heat transfer model coupled with thermo-mechanical effect for the explosive vaporization of melanin granule induced by laser heating was developed to investigate the temperature and thermal damage distribution using alexandrite (755 nm) and Nd:YAG (1064 nm) lasers with the pulse width of 10-120 ns. Cryogen spray cooling (CSC) was introduced to prevent the epidermal thermal damage due to competitive laser absorption between epidermal and dermal melanin. Thermal injury of the epidermis with temperature in the melanin zone reaching 132.3 °C was induced by alexandrite laser. The optimal pulse durations were 50 and 30 ns, and the corresponding incident laser fluence thresholds were 6.45 and 19.5 J·cm-2 for alexandrite and Nd:YAG laser, respectively, with the pre-cooling of R32 spray. Using R32 spray cooling, the 1064-nm laser fluence threshold of melanin can be increased by 56.0%, resulting in an indirect increase (80.4%) of injury thickness. Nd:YAG laser (1064 nm) was highly suitable for the removal of melanin in the deep tissue owing to its deep penetration. Too short pulse duration should be avoided to prevent the epidermal thermal damage. The improvement of therapeutic effect by CSC demonstrates its high clinical application potential.

GNA11 Mutation in an Intracranial Melanocytoma with Orbital Involvement and Nevus of Ota.

The prognostic value of mutations in G-protein genes GNAQ and GNA11 in patients with intracranial and orbital melanocytomas is unknown. The authors present a case of GNA11 mutation (GNA11Q209L) in a 32-year-old male suffering from a meningeal melanocytoma with orbital involvement and ipsilateral Nevus of Ota. The patient underwent gamma knife stereotactic radiosurgery without biopsy and later partial transcranial resection of the melanocytic tumor that was subject to immunohistochemical and molecular analysis. A 50-gene next-generation sequencing panel revealed a 626A>T mutation in the GNA11 gene. One year later, intracranial extension of the melanocytoma necessitated a ventriculoperitoneal shunt and immunotherapy. Future work is needed to determine how GNA11 mutations in melanocytomas influence prognosis and monitoring strategies.

Treatment of nevus of Ota with 1064 nm picosecond Nd:YAG laser: A retrospective study.

Nevus of Ota has been successfully treated by lasers. Currently, 1064 nm picosecond Nd:YAG lasers have become available for the treatment of pigmented disorders. However, there are few studies concerning the application of 1064 nm picosecond Nd:YAG laser in nevus of Ota. This study aimed to evaluate the efficacy and safety of a 1064 nm picosecond Nd:YAG laser for the treatment of nevus of Ota. We conducted a retrospective analysis of Chinese patients with nevus of Ota who had been treated with a 1064 nm picosecond Nd:YAG laser. Those who had any other laser treatment during the period of picosecond laser treatment were excluded. Via a visual analog scale for percentage of pigmentary clearance in standard photographs, the treatment efficacy was assessed by three blinded physician evaluators. A total of 16 subjects were included in this retrospective study. The average age at the beginning of treatment was 16.87 years old (range of 4 months to 59 years), and all patients were of Fitzpatrick skin type IV. Total treatment ranged from 1 to 5 sessions. A 1064 nm picosecond Nd:YAG laser with a mean fluence of 1.8-4.3 J/cm2 was used at 3-12 month intervals. The mean efficacy score for all 16 patients was 2.56 after one session, and the mean efficacy score of 13 patients who completed two sessions and nine patients who completed three sessions were 3.15 and 3.51, respectively. Postinflammatory hyperpigmentation after treatment was only observed in 1 (1/16, 6.25%) patient. The 1064 nm picosecond Nd:YAG laser is an effective and safe approach for treating nevus of Ota.

Novel Application of the 730 and 785 nm Picosecond Titanium Sapphire Lasers for the Treatment of Nevus of Ota.

BACKGROUND AND OBJECTIVES: Nevus of Ota is a benign dermal melanocytosis that may pose significant psychosocial distress to patients. Q-switched nanosecond lasers have traditionally been considered the first-line treatment but pain, bleeding, and postinflammatory pigmentary alteration are common adverse effects. Picosecond devices have been increasingly used to treat nevus of Ota with promising results. We present two cases demonstrating novel applications of the 730 and 785 nm picosecond titanium sapphire lasers for the treatment of nevus of Ota in two patients with types III and IV skin. STUDY DESIGN/MATERIALS AND METHODS: A 730 and 785 nm picosecond titanium sapphire laser with pulse durations of 250 and 300 picoseconds, respectively, were used to treat two cases of nevus of Ota. Four to seven treatment sessions were conducted at monthly intervals, and follow-up evaluation was performed 1-3 months following the final treatment session. RESULTS: Both cases demonstrated greater than 75% clearance following treatment. There were no adverse events or pigmentary alteration noted as a result of picosecond titanium sapphire laser treatment. CONCLUSIONS: The 730 and 785 nm picosecond titanium sapphire lasers are safe and effective for the treatment of nevus of Ota. Lasers Surg. Med. 00:00-00, 2021. © 2021 Wiley Periodicals LLC.

Long-Term Follow-Up for Q-Switched Nd:YAG Treatment of Nevus of Ota: Are High Number of Treatments Really Required? A Case Report.

Objective: Q-switched laser is considered a gold standard treatment for Nevus of Ota (NO). We report how few laser sessions in long intervals of time may achieve satisfying outcomes reducing the rate of possible procedure-linked side effects such as burning, cornea injuries, or hyperpigmentation. Background: NO represents a congenital dermal melanocytosis in the trigeminal distribution majorly occurring in Asian individuals. Multiple reports have shown efficacy and safety of Q-switched laser for the treatment of this condition, but they were based on an empiric regimen, often leading to unnecessary overtreatments. At the best of our knowledge, no long-term follow-up observations of single laser sessions have been conducted to assess the proper intervals and number of treatments. Materials and methods: A 36-year-old Asian woman, Fitzpatrick skin type IV with clinical diagnosis of NO, was treated with 1064 nm 6 ns Q-switched laser one session per year for a total of two sessions. Clinical result was valued by two physicians independently using standardized and polarized light. No use of general anesthesia or sedation was needed in our experience. Corneal shields have been used. Results: After only two sessions of the Q-switched laser performed 1 year apart, the result was excellent with a 95% of clinical response. No side effect was observed. Conclusions: In our experience, Q-switched Nd:YAG laser is an effective treatment for NO with no necessity of high number of treatments. A larger population is needed to confirm this preliminary result.

Comparing the efficacy and safety of Q-switched and picosecond lasers in the treatment of nevus of Ota: a systematic review and meta-analysis.

Nevus of Ota is cosmetically burdensome and often prompts patients to seek treatment. Lasers are commonly used in removing these lesions; however, no systemic analysis has been conducted to support a gold standard laser. To conduct a meta-analysis of the efficacy and safety of Q-switched Nd:YAG lasers (QSNL), Q-switched ruby lasers (QSRL), Q-switched alexandrite lasers (QSAL), and picosecond alexandrite lasers (PSAL) in removing nevus of Ota. Inclusion criteria were nevus of Ota patients treated with QSNL, QSRL, QSAL, or PSAL and documentation of percent clearance and the rate of at least one adverse event. Articles in English, Chinese, or Japanese were included. The prespecified outcome measures were efficacy (percent clearance) and safety (rates of hyperpigmentation, hypopigmentation, scarring, and recurrence). The review included 57 studies and 13,417 patients. The pooled success rate was 64% for QSNL (95% CI 52-76%), 54% for QSRL (95% CI 39-69%), 58% for QSAL (95% CI 44-72%), and 100% for PSAL (95% CI 98-102%). The pooled adverse event rate was 5% for QSNL (95% CI 4-6%), 14% for QSRL (95% CI 9-19%), 9% for QSAL (95% CI 6-12%), and 44% (95% CI 31-57%) for PSAL. QSNL has the most evidence for effectively and safely treating nevus of Ota. PSAL potentially has a superior efficacy; however, further studies are needed to elucidate its side effect profile when treating nevus of Ota.

Caso clínico: nevo de Ota y nevo de Ito asociados a melanocitosis meníngea / Case report: nevus of Ota and nevus of Ito associated with meningeal melanocytosis

INTRODUCCIÓN: El nevo de Ota y el nevo de Ito son melanocitosis dérmicas hiperpigmentarias que surgen como consecuencia de alteraciones o fallas en la migración de los melanocitos desde la cresta neural hacia la epidermis, tienen una etiopatogenia poco conocida y pueden ser congénitas o adquiridas. CASO CLÍNICO: Se trata de un paciente con diagnóstico simultáneo de nevo de Ota y nevo de Ito desde el nacimiento que acude al Servicio de Neurocirugía del hospital Carlos Andrade Marín de la ciudad de Quito y consulta por presentar cefalea súbita de gran intensidad asociada a hemiparesia braquiocrural izquierda. Evolución: Por medio de exámenes complementarios es diagnosticado de dos lesiones ocupantes intracraneales extraaxiales, una parasagital frontoparietal derecha y otra localizada en polo temporal derecho. Se planificó una resección quirúrgica de la lesión parasagital cuyo diagnóstico histopatológico fue melanocitosis meníngea. La lesión de polo temporal fue derivada para tratamiento con Gamma Knife(R). CONCLUSIÓN: Los tumores melanocíticos primarios son extremadamente raros, existe evidencia de su asociación con las melanocitosis dérmicas y en especial con el nevo de Ota. El caso presentado describe la coexistencia de dos melanocitosis dérmicas poco frecuentes (nevo de Ota - nevo de Ito) y un tumor melanocítico primario en el mismo paciente, un caso muy fuera de lo común

BACKGROUND: Nevus of Ota and nevus of Ito are hyperpigmentary dermal melanocytoses which develop as a consequence of disturbances or failures during migration of melanocytes from the neural crest towards the epidermis; they have a relatively unknown aetiopathogenesis and may be congenital or acquired. CASE REPORT: This case involves a male patient with a simultaneous diagnosis of nevus of Ota and nevus of Ito at birth. He attended the Neurosurgery department at Carlos Andrade Marín hospital (Quito) with sudden severe headache associated with left brachio-crural hemiparesis. PROGRESS: Investigations revealed two extra-axial space-occupying lesions, one parasagittal at the right frontal and parietal lobes and the other located at the right temporal lobe pole. A surgical resection was planned for the parasagittal lesion and the histopathological diagnosis was meningeal melanocytosis. The temporal pole lesion was referred for treatment with Gamma Knife(R). CONCLUSION: Primary melanocytic neoplasms are extremely rare. There is evidence of their association with dermal melanocytosis and, in particular, with nevus of Ota. This highly unusual case describes the coexistence of two very rare dermal melanocytoses (nevus of Ota and nevus of Ito) and a primary melanocytic neoplasms in the same patient

Combination of 1064-nm Q-switched neodymium-doped yttrium-aluminum-garnet laser with Modified Jessner's peel for the treatment of Nevus of Ota: A case series of seven patients.

1064-nm Q-switched Nd: YAG (neodymium-doped yttrium-aluminium-garnet) laser is widely used for the treatment of Nevus of Ota but multiple treatments are necessary for clinical improvement. Superficial chemical peeling using Modified Jessner's solution has been used for the treatment of facial pigmentation but repetitive chemical peeling can cause irritation and post-inflammatory hyperpigmentation. In this series, we evaluated seven patients who were treated with a combination of 1064-nm Q-switched Nd: YAG laser and Modified Jessner's peel for eight sessions with 85.7% patients showing more than 50% reduction in pigmentation. The added therapeutic benefit of the combination helped to achieve a significant reduction in pigmentation faster with a lesser number of sessions and reduced cost.

Use of a Picosecond Alexandrite Laser for Treating Acquired Bilateral Nevus of Ota-Like Macules in Chinese Patients.

BACKGROUND AND OBJECTIVES: Acquired bilateral nevus of Ota-like macules (ABNOM) is common among the Chinese population. There have been few studies on the use of a picosecond alexandrite laser for the treatment of ABNOMs. The goal of this study was to evaluate the efficacy and safety of a 755 nm picosecond alexandrite laser for the treatment of ABNOMs. STUDY DESIGN/MATERIALS AND METHODS: A total of 225 subjects diagnosed with ABNOMs were included in this retrospective study. A 755 nm picosecond alexandrite laser system was used to treat all subjects. The safety and effectiveness of the laser were determined using a clinical photo assessment. The correlating factors of the patients, including the age, Fitzpatrick skin type, lesion location, lesion color, treatment procedures, melasma, and outcomes, were analyzed. RESULTS: The patients underwent one to four treatment sessions with clinical clearance (>90%) rates of 8.89%, 30.99%, 56.65%, and 60.00%, respectively. A higher number of sessions was positively associated with a better treatment response. The hyperpigmentation incidence rate was 22.67%, and one case of hypopigmentation was observed. CONCLUSION: Our results suggest that a picosecond alexandrite laser is an effective and safe approach for treating ABNOMs in Chinese patients. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

Comparison of a picosecond alexandrite laser versus a Q-switched alexandrite laser for the treatment of nevus of Ota: A randomized, split-lesion, controlled trial.

BACKGROUND: Novel picosecond lasers have been available for various pigmentary disorders. However, there are limited data directly comparing picosecond lasers and Q-switched lasers for treatment of nevus of Ota. OBJECTIVE: To compare the efficacy and safety of a picosecond alexandrite laser (PSAL) with a Q-switched alexandrite laser (QSAL) for the treatment of nevus of Ota. METHODS: Each lesion of 56 enrolled participants was split into 2 parts and randomly assigned to either the PSAL or QSAL treatment arm. Each lesion was treated in up to 6 sessions in 12-week intervals. Efficacy and safety were determined using blinded visual evaluation and self-report at each follow-up visit. RESULTS: The PSAL arm achieved a significantly better clearance (5-point scale, PSAL 4.53 vs QSAL 4.0) with fewer sessions (PSAL 5.26 vs QSAL 5.87) and less severe pain (Visual Analog Scale, PSAL 5.61 vs QSAL 6.40). Patients were more satisfied with PSAL than QSAL (Likert scale, 4.5 vs 4.0). Occurrences of postinflammatory hyperpigmentation (PSAL 26% vs QSAL 34%) and hypopigmentation (PSAL 21% vs QSAL 47%) were also lower in PSAL than QSAL arm. LIMITATIONS: Lack of objective assessments and outcome measures. CONCLUSION: PSAL demonstrated better clinical results and fewer adverse events than QSAL for the treatment of nevus of Ota.

Successful treatment of a patient with multicolored nevus of Ota using a combination of 1064 and 532 nm Q-switched Nd:YAG lasers.

Nevus of Ota (NO) is a hamartoma of dermal melanocytes usually presents as unilateral blue, gray or brown macules or patches. It can impose a high burden of cosmetic and psychological disturbances in affected individuals. Q-Switched lasers appear to be an effective treatment for this kind of dermal melanocytosis. Multicolored Ota nevus is a rare variant of this kind of nevus and its treatment may be more challenging compared with unicolor lesions. Herein we report a 21-year-old woman with a multicolored nevus of Ota (blue and brown), which showed a dramatic response to a combination of 1,064 nm and 532 nm Q-Switched Nd:YAG lasers. We also discuss different aspects of the Q-switched laser application of Ota nevus treatment. We also focus on laser combination therapy to treat the nevus of Ota.