Treatment and Classification of Nevus of Ota: A Seven-Year Review of a Single Institution's Experience

Abstract

BackgroundNevus of Ota (NO) is a relatively common pigmentary disorder in Asians. Tanino's classification is an old but tacit consensus to delineate the disease. Various treatment options have been presented. However, a few studies have been conducted on available laser options and current treatment strategies or the classification of NO.ObjectiveTo investigate current laser options and their effectiveness for the treatment of NO, contributing factors to clinical outcomes, and verification of classification.MethodsA retrospective study of NO was conducted by reviewing medical charts and photographs of sixty-seven patients. Statistical analysis was used to compare excellent and poor outcomes and determine contributing factors.ResultsThe median age of onset was below the age of 1 (interquartile range [IQR], 0~1). Tanino's and PUMCH classification systems failed to classify patients in 24 (35.8%) and 6 (9.0%) of patients, respectively. A 1,064 nm Q-switched Nd:YAG laser without additional lasers was used most frequently in 42 patients (62.7%). The frequency of treatment was 19.0 (IQR, 10.0~23.0) in the cured group defined as subjects showing 95% improvement or above, compared to 10.0 (IQR, 6.25~13.75) in the unattained group defined as subjects showing less than 95% improvement (p=0.001).ConclusionA 1,064 nm Q-switched Nd:YAG laser is a reliable treatment armamentarium, functioning as a single infallible modality as well as a combination treatment modality for NO. Repetitive laser treatments without interruption seems to be the most suitable in clearing NO. The current classification systems of NO are defective. Thus, a new classification should be developed.

Treatment of Laser-Responsive Dermal Pigmentary Conditions in Type III-IV Asian Skin With a 755-nm Picosecond Pulse Duration Laser: A Retrospective Review of Its Efficacy and Safety

“…Two patients (3%) experienced persistent side effects such as an atrophic scarring, although it was not mentioned how many sessions these patients underwent. 12 A recent split-face study by Ge and colleagues 13 using a picosecond 755-nm alexandrite laser versus the ns-QS 755-nm alexandrite laser for treatment of NO in skin Types III-IV showed higher efficacy and a decrease in pain scores and postinflammatory hyper/hypopigmentation in the picosecond laser–treated group.…”

Combination of 1064‐nm Q‐switched neodymium‐doped yttrium‐aluminum‐garnet laser with Modified Jessner's peel for the treatment of Nevus of Ota: A case series of seven patients

“…The Q‐switched Nd: YAG lasers produce nanosecond pulses of laser light targeting and destroying the melanosomes without affecting the surrounding tissue. Various wavelengths have been used in the treatment of Nevus of Ota, but because of its longer wavelength and subsequently deeper penetration, 1064‐nm Q‐switched Nd: YAG laser is considered as the first choice for the treatment of Nevus of Ota 10 . The long wavelength allows the laser to penetrate about 4 to 6 mm into the skin before the energy is scattered hence it works on deeper lesions with minimal absorption by the melanin.…”

Efficacy and safety of picosecond 755‐nm alexandrite laser for treatment of nevus of Ota in Taiwanese children: A retrospective study

“…Clinical photographs captured before each treatment and at follow‐up visits were assessed. Two dermatologists blinded to patients' treatment conditions evaluated the overall facial pigmentation based on a five‐category grading system of lesion clearance: clear, 95%–100%; excellent, 75%–94%; good, 50%–74%; fair, 25%–49%; poor, 0%–24% 6,29,32 . Transient and permanent adverse responses associated with laser treatment, including swelling, scarring, crusting, erythema, blistering, bleeding, hypopigmentation, and hyperpigmentation 25,29 after treatment and at follow‐up visits, were verified according to the medical records.…”