Are Q-switched lasers for Nevus of Ota really effective in pigmented skin?

Sardana, Kabir; Chugh, Shikha; Garg, Vijay Kumar

doi:10.4103/0378-6323.93639

Cited by 10 publications

(10 citation statements)

References 11 publications

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“…In spite of the different lasers available, recurrences have been reported in NOA after complete clearance with laser treatment varying from 0.6% to 1.2% . But our focus is restricted to the issue of nonresponsive or partially responsive cases of nevus of ota . This is usually a common occurrence in pigmented skins .…”

Section: Discussionmentioning

confidence: 99%

“…Variations in depth and density of dermal melanocytes account for differences in lesional color due to the Tyndall effect, in which longer wavelengths of light are absorbed by dermal melanin while shorter wavelengths are reflected. The almost dogmatic use with QS‐1064 nm in pigmented skin, discounting the color and depth of the lesion could account for the variable results . It has been confirmed histologically that the depth of melanocytes within NOA varies according to lesional color and site .…”

Section: Factors That Predict Responsementioning

confidence: 96%

“…In spite of the plethora of science behind laser‐tissue interactions, the objective evaluation of response of NOA to lasers is not on firm footing with most studies report subjective percentile scoring improvement . Even though QSRL is superior to QS Nd: YAG, lightening of 70% has been reported in the majority of patients treated with the QSRL, and thus, not all cases respond to QSRL.…”

Section: Ideal Lasermentioning

confidence: 99%

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Variables that predict response of nevus of ota to lasers

Rani

Sardana

2019

J of Cosmetic Dermatology

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Nevus of ota (also known as oculodermal melanocytosis or nevus fuscoceruleus ophthalmomaxillaris) is a mottled, blue-gray macule that is usually located unilaterally within the distribution of the first and second branches of the trigeminal nerve. Nevus of ota (NOA) is congenital in about 50% of cases, while in other cases it appears by the second decade of life. 1 Acquired nevus of ota-like macules (also known as Hori's nevus) differ from the classic nevus of ota in that they are bilateral, spare mucosa, and occur later in life. 2 | RELE VANT L A S ER-TISSUE INTER AC TI ON SThe ability of laser and light sources to diminish pigmented lesions is based on the principle of selective photothermolysis which had predicted that for selective thermal damage to an absorbing target, the correct laser wavelength, and appropriate pulse duration relevant to the target organelle must be ensured. For this, the wavelength should correspond to the absorption characteristics of the target, the pulse duration should be shorter than the thermal relaxation time and in case of NOA should have a deep penetration. 3 Here, the target is the melanosomes for which a Q-switched (QS) mode is ideal. 4,5 Other lasers that can be used include the pulsed tunable dye laser (wavelength 435-750 nm, pulse width 300-750 ns), 6,7 Q-switched ruby laser (QSRL;wavelength 694 nm, pulse width 40 ns), 5 and the Q-switched Nd:YAG(neodymium-doped yttrium aluminum garnet; wavelength 355, 532, and 1064 nm, pulse width 10-12 ns). 8 Anderson et al performed a study using 12 ns Q-switched Nd-YAG (neodymium-yttrium-aluminum-garnet) laser pulses at 355, 532, and 1064 nm in pigmented and albino guinea pig skin. At each wavelength, melanosomes were ruptured within keratinocytes and melanocytes, with cytoplasmic and nuclear alterations. 8Selective injury to melanosomes and pigmented cells occurs after 351 nm (15 ns duration) ultraviolet laser pulses, 4,9 or 694 nm (40 ns duration) red pulses from a Q-switched ruby laser. 5,10 For these wavelengths, absorption by melanin dominates over that by blood, 11 and the site of primary injury appears to be melanosomes. While shorter wavelengths, such as 351 nm are better at absorbed by melanin, longer wavelengths penetrate deeper into the skin, increasing their ability to reach the deeper melanosomes. | IDE AL L A S ERWhile the QSRL has been the most widely used laser for NOA, [12][13][14] the Q-switched alexandrite (QSA) 15 and QS Nd: YAG lasers are as effective as compared to Q-switched ruby laser. As the QSRL has a higher absorption spectrum for melanin, it can lead to pigmentary SummaryNevus of ota is a dermal melanocytosis common among Asian patients, mottled, blue-gray macule that is usually located unilaterally within the distribution of the first and second branches of the trigeminal nerve and almost always responds well to treatment with Q-switched lasers (eg, ruby, alexandrite, and Nd: YAG). In spite of the plethora of science behind laser-tissue interactions, the objective evaluation of nevus of ota response to la...

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Section: Discussionmentioning

confidence: 99%

Section: Factors That Predict Responsementioning

confidence: 96%

Section: Ideal Lasermentioning

confidence: 99%

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Variables that predict response of nevus of ota to lasers

Rani

Sardana

2019

J of Cosmetic Dermatology

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“…In pigmented skin, the results are not as good as in western skin types as the pigment in the epidermis alters the laser physics dynamics. [7] In the study, the difference in the improvement of the peel group (40.44%) and the low fluence laser group (47.93%) was not markedly different though it apparently achieved statistical significance. [1] It would have been informative to know at which sitting did this difference emerge and the statistical comparison between the two groups is not mentioned in the plethora of tables in the text, which probably is an oversight.…”

Section: Sirmentioning

confidence: 78%

Which therapy works for melasma in pigmented skin: Lasers, peels, or triple combination creams?

Sardana

Chugh

Garg

2013

Indian J Dermatol Venereol Leprol

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“…Tedavide kozmetik kamuflaj, Q-Switched Nd-YAG laser ile başarılı sonuçlar alınabilir [11,12]. Bizim hastamızı tedavi olarak laser ve kamuflaj konusunda bilgilendirdik.…”

Section: Olgu Sunumuunclassified

Bilateral Ota nevus in a 15 years old patient

Öztürk¹,

Uçak²,

Erden³

2013

DicleMedj

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Nevus of Ota is a dermal melanocytosis, clinically localized on skin that is innervated by the first and second branches of the trigeminal nerve. It occurs almost entirely in Asian people. The clinical manifestations are usually unilateral; only 5% of cases are bilateral. In this article, due to rarity of the case, a 15-year-old patient, who was diagnosed with bilateral ota nevus, without having any dermatological complaints other than cosmetic appearence and stains in her eyes and around was presented.

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Are Q-switched lasers for Nevus of Ota really effective in pigmented skin?

Cited by 10 publications

References 11 publications

Variables that predict response of nevus of ota to lasers

Variables that predict response of nevus of ota to lasers

Which therapy works for melasma in pigmented skin: Lasers, peels, or triple combination creams?

Bilateral Ota nevus in a 15 years old patient

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