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THE EFFICACY AND SAFETY OF SHORT PULSE ERBIUM:YAG LASER IN THE TREATMENT OF ACQUIRED MELANOCYTIC NEVI

THE EFFICACY AND SAFETY OF SHORT PULSE ERBIUM:YAG LASER IN THE TREATMENT OF ACQUIRED MELANOCYTIC NEVI. Mete Baba*, Deniz Seçkin*, Nebil Bal** Başkent University Faculty of Medicine Department of Dermatology* and Pathology** .

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THE EFFICACY AND SAFETY OF SHORT PULSE ERBIUM:YAG LASER IN THE TREATMENT OF ACQUIRED MELANOCYTIC NEVI

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  1. THE EFFICACY AND SAFETYOF SHORT PULSE ERBIUM:YAG LASER IN THE TREATMENT OF ACQUIRED MELANOCYTIC NEVI Mete Baba*, Deniz Seçkin*, Nebil Bal** Başkent University Faculty of Medicine Department of Dermatology* and Pathology**

  2. No study evaluating the efficacy and safety of an erbium:YAG laser with its small penetration depth and fewer adverse effects in the treatment of acquired melanocytic nevi.

  3. Objective • To investigate the efficacy and safety of short pulse erbium:YAG laser in the treatment of acquired melanocytic nevi

  4. Patients and Methods • Patient selection and consent • Laser treatment • Follow-up • Biopsy and histopathologic assessment

  5. Inclusion criterias • Benign-appearing melanocytic nevi (clinically and dermatoscopically) • Nonfacial localization • Diameter < 6 mm • Flat or just palpable

  6. Lazer treatment 2940 nm 1 J 5 Hz 300 µs

  7. Follow-up • Wound healing • Infection • Scarring • Pigmentary changes

  8. Biopsy and histopathologic assessment • Biopsy (punch) • Histochemical examination • H&E • Masson-Fontana • Immunohistochemical examination • S-100 • HMB-45

  9. Results • 14 patients (10 women and 4 men; aged, 21-38 years; mean, 32.6 years). • Four to ten pulses of laser irradiation were sufficient for clinical removal of all nevi • Epithelization time was between 7 and 10 days • Redness persisted up to 3 weeks in all cases

  10. Results-Safety • Infection; no • Postinflammatory hyperpigmentation; 2 cases • Hypopigmentation; 3 cases

  11. Results-Efficasy • Completeremoval; clinically; all of the nevi, and histopathologically, 27 of 28 nevi • Nevus cells located in dermis (at a depth of 0,25mm); only one specimen

  12. Findings-Histopathology • Epidermis; normal • Dermis; mild fibrosis ranging between 0.19-0.28 mm (mean, 0.24 mm) • Perivascular lymphocyte and eosinophil infiltration; 7 specimens • Several melanophages; 4 specimens

  13. Discussion-Efficasy The depth of vaporization; 2-4 µm for each 1 J/cm2, 4 to 10 pulses of erbium:YAG laser irradiation at fluencies between 5.2 and 14.4 J/cm2 are sufficient to remove nevus cells in the dermo-epidermal junction and the upper dermis. In 1 nevus in this study, incomplete

  14. Discussion-Safety • Melanin pigment içeriği az olan nevüs hücrelerinde yeterli harabiyetin oluşmaması • Epidermal pigment yoğunluğunun blokaj etkisi nedeni ile lazer ışınlarının daha alt seviyelerdeki nevüs hücrelerine ulaşamaması

  15. Malignant transformation • Laser ? Malignant transformation

  16. Erbium: YAG lazer; safe and effective

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