RESUMO
We present the case of a 16-year-old boy with Peutz-Jeghers disease with successful treatment of oral lentiginosis with one session of picosecond 755-nm alexandrite laser. To date, only in one other article picosecond laser is used for lentiginosis in Peutz-Jeghers disease. Other therapeutical options include Q-switched 755-nm alexandrite, 1064-nm Nd:YAG, 532-nm KTP-laser, ruby and intense pulsed light, which generally require more sessions, are less pigment-selective and have overall worse results than picosecond laser treatment.
Assuntos
Terapia a Laser , Lasers de Estado Sólido , Lentigo , Síndrome de Peutz-Jeghers , Adolescente , Berílio , Humanos , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Lentigo/etiologia , Lentigo/radioterapia , Lentigo/cirurgia , Masculino , Síndrome de Peutz-Jeghers/complicações , Síndrome de Peutz-Jeghers/radioterapia , Síndrome de Peutz-Jeghers/cirurgia , Resultado do TratamentoRESUMO
Labial lentigines associated with Peutz-Jeghers syndrome are challenging and represent a cosmetic problem. Laser and intense-pulsed light sources (IPLS) can be used to treat these macules. However, there are few guidelines regarding the different types of protocols found in the literature. Thus, the purpose of this study was to review the pertinent literature on lasers and IPLS as therapy for labial lentigines in patients with Peutz-Jeghers syndrome. A detailed literature search was conducted in seven databases (Cochrane Library, Embase, Lilacs, PubMed, SciELO, Scopus and Web of Science) to November 2020. Data were extracted and analyzed from selected studies including study design, sample size, participants' skin color, age, and gender, parameters of the laser or IPLS used, interval and total sessions of laser application, results obtained, follow-up time and side effects. Thirteen out of 124 published studies met our eligibility criteria, covering 81 patients. Ten types of lasers and IPLS were used, and most of the sample (n = 57) was treated with Q-switch Alexandrite Laser (QSAL). The total number of sessions ranged from 1 to 12 and the interval between sessions ranged from 2 to 16 weeks. All studies have shown satisfactory results, with no further complications. The follow-up ranged from 2 to 97 months. Laser therapy and IPLS are effective in the treatment of lentigines associated with PJS. Although QSAL was used in 70.3% of the sample, different types of lasers showed comparable satisfactory results.
Assuntos
Terapia a Laser , Lentigo , Doenças Labiais , Terapia com Luz de Baixa Intensidade , Melanose , Síndrome de Peutz-Jeghers , Humanos , Lentigo/radioterapia , Terapia com Luz de Baixa Intensidade/efeitos adversos , Terapia com Luz de Baixa Intensidade/métodos , Síndrome de Peutz-Jeghers/complicações , Síndrome de Peutz-Jeghers/diagnóstico , Síndrome de Peutz-Jeghers/radioterapiaAssuntos
Lasers de Estado Sólido , Terapia com Luz de Baixa Intensidade/métodos , Síndrome de Peutz-Jeghers/diagnóstico , Síndrome de Peutz-Jeghers/radioterapia , Transtornos da Pigmentação/diagnóstico , Transtornos da Pigmentação/radioterapia , Adolescente , Povo Asiático , Feminino , Humanos , Masculino , Resultado do TratamentoRESUMO
BACKGROUND AND OBJECTIVE: Labial lentigines associated with Peutz-Jeghers syndrome are cosmetically disfiguring and distressful. Although multiple treatment modalities including Q-switched ruby laser and Q-switched alexandrite laser have been proposed, experience with Q-switched Nd:YAG laser has been lacking. This study aimed to retrospectively evaluate the efficacy and safety of Q-switched Nd:YAG laser (532 nm) for labial lentigines in Peutz-Jeghers syndrome. PATIENTS AND METHODS: Demographic and clinical data of 11 patients diagnosed with Peutz-Jeghers syndrome were analyzed. A quartile grading system was used. All patients were treated with a Q-switched Nd:YAG laser system with the following parameters: wavelength 532 nm; spot size 3 mm; pulse duration 5-20 ns; fluence 1.8-2.2 J/cm(2) . RESULTS: After two to six (mean 3.6) treatment sessions, an average grade of 3.73 was achieved. Eight patients (72.7 %) showed an excellent response with more than 75 % lesion clearance. Three patients (27.3 %) showed a good response. Repeated treatments led to improved clearance of labial lentigines. Age, gender, and Fitzpatrick skin type were not statistically associated with efficacy grades after the first treatment session. Neither recurrence in treated areas nor significant complications were observed. CONCLUSIONS: Q-switched Nd:YAG laser provides an effective and safe treatment option for labial lentigines associated with Peutz-Jeghers syndrome.
Assuntos
Lasers de Estado Sólido/uso terapêutico , Doenças Labiais/patologia , Doenças Labiais/radioterapia , Terapia com Luz de Baixa Intensidade/métodos , Síndrome de Peutz-Jeghers/patologia , Síndrome de Peutz-Jeghers/radioterapia , Adolescente , Adulto , Feminino , Humanos , Masculino , Resultado do Tratamento , Adulto JovemRESUMO
Resumo: Os autores relatam um caso de uma mulher, de 28 anos de idade, com intussuscepçäo ileocecocólica associada à síndrome de Peutz-Jeghers, uma doença autossômica dominante caracterizada por pópolis harmartomatosos no trato gastrointestinal e pigmentaçäo mucocutânea. Esta patologia apresenta complicaçäo frequêntes, tais como obstruçäo intestinal por intussuscepçäo e hemorragia. No caso aqui apresentado, o diagnóstico da invaginaçäo foi pré-operaatório, por meio de exames de imagem. A paciente foi submetida a laparotomia, durante a qual foi realizada hemicolectomia direta. Na peça cirúrgica foram encontrados três pólipos de grandes dimensöes, interpretados como sendo a causa da intussuscepçäo
