We describe the diversity of indications for laser hair removal (LHR) therapy and compare our experience with the literature. Patients' case notes referred to the Birmingham Regional Skin Laser Centre between 2003 and 2011 for laser hair removal, with indications other than hirsutism, were reviewed retrospectively. Thirty-one treated patients with the following indications were identified: hair-bearing skin grafts/flaps, intra-oral hair-bearing flap, Becker's naevus, localised nevoid hypertrichosis, peristomal hair-bearing skin, scrotal skin prior to vaginoplasty in male-to-female (MTF) gender reassignment, pilonidal sinus disease (PSD), pseudofolliculitis barbae (PFB) and hidradenitis suppurativa (HS). Seven patients with the following indications have been reported before: intra-oral hair-bearing graft, naevoid hypertrichosis and peristomal hair-bearing skin. A clinical review of the evidence available for each indication is provided. Our experience and that in the published literature suggest that LHR is a safe, well-tolerated and effective treatment modality for the indications we report, leading to significant symptom and functional improvement with high patient satisfaction. LHR appears effective in the treatment of chronic inflammatory conditions such as PSD, PFB and HS, particularly at an early disease stage. We aim to increase awareness of the diversity of laser hair removal indications and add evidence to the medical literature of the wide range of indications for this useful treatment modality.
A 53-year-old man was referred to Dermatology with a 12-week history of painful bilateral fungating lesions arising from the great toenail beds (a). He was undergoing treatment for metastatic renal cell carcinoma (RCC) with tyrosine kinase inhibitor sunitinib. A skin biopsy (b) of the right great toe demonstrated a dermal infiltration of atypical spindled epithelioid cells positive for pancytokeratin (c) and CD10 (d), in keeping with metastatic RCC. Metastatic deposits were confirmed in the subsequent bilateral hallux amputations. RCC commonly metastasizes to the lymph nodes, lung, bone, liver and brain. 1 This is the first report of symmetrical hallux acrometastases. 2 We wish to highlight this rare metastatic phenomenon which may present to the Dermatology clinic in the first instance. References 1 Motzer RJ, Bander NH, Nanus DM. Renal-cell carcinoma. N Engl J Med 1996; 335:865-75. 2 Mavrogenis AF, Mimidis G, Kokkalis ZT et al. Acrometastases. Eur J Orthop Surg Traumatol 2014; 24:279-83.Funding sources: no external funding.Conflicts of interest: none to declare.
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