Comparison of Electrodesiccation and Potassium-Titanyl-Phosphate Laser for Treatment of Dermatosis Papulosa Nigra

Kundu, Roopal V.; Joshi, S.; Suh, Ki Young; Boone, Susan L.; Huggins, Richard H.; Alam, Murad; White, Lucile E.; Rademaker, Alfred; West, Dennis P.; Yoo, Simon

doi:10.1111/j.1524-4725.2009.01186.x

Cited by 29 publications

(24 citation statements)

References 6 publications

(9 reference statements)

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“…Kundu KTP laser for DPN in 14 subjects (skin type IV to VI) with a split-face model and the study demonstrated that in terms of efficacy, the ED and KTP lasers had no significant difference. The analysis showed that a small number of patients experienced discomfort with KTP laser as compared to ED, in the event of both cases having no administration of anesthesia in the study protocol [5] . In darker skin types, the most detrimental side effect is post-inflammatory pigment alteration.…”

Section: Discussionmentioning

confidence: 99%

“…The better outcome in terms of pigmentary complication in our study was explained by the accurate depth assessment and the dried residue being left as it was after reaching the end point without wiping it out. Along with that, we prescribed post-procedural topical antibiotic and least potent steroid combination for a certain period of days with sunscreen applied, which contributed to the result [5] . Minor side effect profile was observed in darker skin type.…”

Section: Discussionmentioning

confidence: 99%

“…All preoperative photographs as well as 2-week, 4-week and 8-week post-procedure photographs were examined by two independent dermatologists who had no prior information concerning the procedure or patient selection, (both known hereafter as "blinded observer") to rate the efficacy and side effects. Efficacy was analyzed as poor improvement (0-25%), fair (26%-50%), good (51%-75%), or excellent (76%-100%) by counting completely cleared lesions [5] . Side effects were examined in terms of hypo/hyperpigmentation and scarring.…”

Section: Methodsmentioning

confidence: 99%

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Electrosurgery in Dermatosis papulosa nigra: An effective, well-tolerated but less documented tool

et al. 2016

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Dermatosis papulosa nigra (DPN) is a superficial, black or brown benign papule that develops mainly in dark-skinned individuals over the face and neck. Clinically seborrheic keratosis shows a stuck-on appearance that differentiates it from DPN. Histopathological examination describes that both are identical. Many types of lasers are used as treatments for it. Traditional surgical procedures such as curettage, electrosurgery, and snip/shave excision are still considered as a therapeutic modality. Although electrodesiccation (ED) is a simple procedure, studies on ED use for DPN with a good number of cases are lacking. This paper presents the evaluation safety, efficacy and cost-effectiveness of ED for the treatment of DPN in Fitzpatrick"s skin type IV to VI. A total of 40 patients (11 male and 29 female) with DPN over the face and neck with skin type IV-VI were included. Superficial ED (monopolar, low, 2-3.5 W) was done by just touching the lesion under topical anesthesia. All preoperative photographs as well as 2-, 4-and 8-week post-procedure photographs were examined by two independent dermatologists who had no prior information concerning the procedure, (both known hereafter as "blinded observer"): one for examining efficacy in terms of poor improvement (0%-25%), fair (26%-50%), good (51%-75%), or excellent (76%-100%), by counting completely cleared lesions; and the other for examining side effects in terms of hypo/hyperpigmentation and scarring. As a result, 85% of patients showed excellent improvement (>75% clearance), 7.5% good (51%-75% clearance), 5% fair (26%-50% clearance) and 2% poor (0-25% clearance) as measured by the "blinded" observer. Post-inflammatory hyperpigmentation was observed in 15% cases, whereas hypo-pigmentation was documented in 7.5% cases. Only in two cases (5%) was lesional scarring noted. Those complications were cleared after eight weeks. In this study, ED was observed to be an effective, well-tolerated and cost-effective method for treatment of DPN in colored skin. Complications were few, and therapy was performed appropriately with effective postoperative measures. Keywords: Dermatosis papulosa nigra (DPN); electrodesiccation; colored skinCitation: Gorai S, Seth J, Bindal A, Samanta AB, Nag S, et al. Electrosurgery in dermatosis papulosa nigra: An effective, well-tolerated but less documented tool.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Electrosurgery in Dermatosis papulosa nigra: An effective, well-tolerated but less documented tool

et al. 2016

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“…In dark-skinned patients, electrodessication is preferred using low settings of 0.4-0.8 watts on a standard hyfrecator with a pointed tip. Further reports suggest using long pulsed 1064-nm Nd:YAG, 532-nm diode laser, 595-nm pulsed-dye laser, fractionated photo thermolysis 1550 nm, potassium-titanyl-phosphate (KTP), and carbon dioxide ablative lasers [66,[70][71][72][73][74].…”

Section: Treatmentsmentioning

confidence: 99%

Facial Hyperpigmentation in Skin of Color: Special Considerations and Treatment

et al. 2016

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Differences in cutaneous diseases in people of color call for nuanced evaluation and management. One of the most common dermatological complaints from patients with skin of color is dyspigmentation, particularly hyperpigmentation. The challenge for clinicians is to establish correct diagnoses along with consistently successful treatments to meet the needs of the increasingly diverse population served. This review focuses on facial hyperpigmentation and outlines the most common skin disorders and treatment options.

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“…The use of lasers for DPN has not demonstrated significant efficacy advantages over traditional approaches (electrodesiccation with or without curettage), but improved patient comfort vs. electrodesiccation has been reported with the potassium-titanyl-phosphate laser. 49 …”

mentioning

confidence: 99%

Lasers and light-based therapies in ethnic skin: treatment options and recommendations for Fitzpatrick skin types V and VI

Alexis

2013

Br J Dermatol

111

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SummaryEthnic skin or 'skin of colour', which is characterized by increased epidermal melanin, labile melanocytes and reactive fibroblast responses, poses special challenges for the use of laser and light-based therapies. These therapies are associated with a greater risk of dyspigmentation and scarring in ethnic skin and therefore require careful selection of device and treatment parameters to minimize complications. Whereas early-generation lasers for hair removal and resurfacing were generally contraindicated for individuals with Fitzpatrick skin phototypes (SPT) IV-VI, advances in the past decade have given rise to a range of devices that can be safely used in ethnic skin. Longer wavelength lasers such as the 810 and 1064 nm Nd:YAG; intense pulsed light and monochromatic excimer light (308 nm); fractional lasers; and radiofrequency devices have all been used safely for hair removal, pigmentary abnormalities, resurfacing and skin tightening in ethnic skin, respectively. Notwithstanding these advances, nuances in the laser or light treatment of darker skin types remain and must be considered to ensure safe therapeutic outcomes. The vast majority of published data pertaining to lasers and light treatments in nonwhite skin involve patients of East Asian ethnicity (e.g. Korean, Japanese, Chinese, Thai). By contrast, there is a paucity of studies involving individuals of African ancestry or those with SPT V or VI. This article will review laser and light-based modalities that are considered safe and effective for individuals with richly pigmented skin. What's already known about this topic?• Published data or recommendations on the safe and effective use of lasers in Fitzpatrick skin phototypes (SPT) V and VI are limited. What does this study add?• This review addresses knowledge and practice gaps by summarizing available data on the use of lasers in patients with SPT V and VI, a subset of the population in which the risk of iatrogenic pigmentary and scarring complications is highest.• This provides clinicians with practical knowledge of which devices have been studied in SPT V and VI and offers treatment recommendations to improve outcomes.Traditionally, the literature on cosmetic procedures, especially laser and light-based therapies, has focused on the treatment of individuals of European ancestry with Fitzpatrick skin phototypes (SPT) I-III. Safety limitations of first-generation technologies as well as socioeconomic, demographic and cultural factors may contribute to the relative lack of studies involving the various racial/ethnic groups with constitutively darker skin. Shifts in the aforementioned contributing factors have led to considerable increases in the performance of cosmetic procedures in nonwhite racial/ethnic groups. According

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Comparison of Electrodesiccation and Potassium-Titanyl-Phosphate Laser for Treatment of Dermatosis Papulosa Nigra

Abstract: Although treatment of DPN with KTP laser and electrodesiccation are comparable in efficacy, KTP laser is preferable for patient comfort.

Cited by 29 publications

References 6 publications

Electrosurgery in Dermatosis papulosa nigra: An effective, well-tolerated but less documented tool

Electrosurgery in Dermatosis papulosa nigra: An effective, well-tolerated but less documented tool

Facial Hyperpigmentation in Skin of Color: Special Considerations and Treatment

Lasers and light-based therapies in ethnic skin: treatment options and recommendations for Fitzpatrick skin types V and VI

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