Treatment of Café‐Au‐Lait Spots Using Q‐Switched Alexandrite Laser: Analysis of Clinical Characteristics of 471 Children in Mainland China

Abstract

Background and Objectives Café‐au‐lait spots, also known as café‐au‐lait macules (CALMs), are a common pigmentary disorder. Although various laser modalities have been used to treat CALMs, the efficacy of laser treatment in children differs from that in adults. We investigated the efficacy, safety, and clinical factors of the treatment of CALMs using Q‐switched alexandrite laser (755 nm) therapy in children. Methods In total, 471 children with CALMs underwent Q‐switched alexandrite laser therapy at a treatment interval of 3–12 months. The safety and efficacy of the laser treatment were evaluated by reviewing clinical records and photographs before and after treatments. Results Of the 471 patients, 140 (29.72%) were cured completely, 124 (26.33%) showed substantial improvement, 110 (23.35%) showed improvement, and 97 (20.60%) showed no improvement after one to nine treatments. The overall treatment success rate was 79.41%, and the treatment efficacy was positively correlated with the number of laser treatments (rs = 0.26, P < 0.0001). Sex and the interval of laser treatments were also associated with significant differences in treatment outcomes (P < 0.05). No obvious adverse effects were observed. Multivariate logistic regression analysis showed that the number of treatments influenced the treatment efficacy (odds ratio, 2.130; 95% confidence interval, 1.561–2.908). Conclusions Q‐switched alexandrite laser (755 nm) therapy is safe and highly effective for CALMs in children, and the number of treatments affects the treatment efficacy. Lasers Surg. Med. © 2019 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

Comparative Effectiveness of 755‐nm Picosecond Laser, 755‐ and 532‐nm Nanosecond Lasers for Treatment of Café‐au‐Lait Macules (CALMs): A Randomized, Split‐Lesion Clinical Trial

“…In previous studies, 10 in 22 (45.5%) patients treated with the QS‐532 nm laser achieved complete lightening [26]. Kagami [27], Wang [28], and Zhang [29] reported two in 26 (7.6%), five in 48 (10.4%), and 140 in 471 (29.72%) patients treated with the QS‐755 nm laser achieved complete lightening, respectively. As Chan [19] used PS‐755 nm for treating patients with CALMs and achieved fair to good response, many other researchers have used PS‐755 nm, PS‐532 nm, and dual‐wavelength picosecond (only 532 nm wavelength) to treat cases of CALMs [20,30,31].…”

Comparison of the safety and efficacy of low fluence Q‐switched 1064‐nm and conventional Q‐Switched 755‐nm lasers in the treatment of café‐au‐lait macules: A prospective self‐controlled trial

“…There is no significant difference in the recurrence rate between the two laser treatments. After HFQS 755‐nm laser treatment, 65% of patients ( n = 13) experienced temporary hypigmentation, and the average remission time was 8 weeks (range 2−12 weeks), more than in previous studies (0%−2.44%) 3,22 . Follow‐up visits may not have been frequent enough in previous studies, resulting in a lack of relevant records 3,22 .…”

“…3,22 Follow-up visits may not have been frequent enough in previous studies, resulting in a lack of relevant records. 3,22 In our study, one patient (5%) experienced persistent mottled hypopigmentation after LFQS 1064-nm laser treatment. Researchers believed that the cause of this side effect was the cumulative phototoxic damage caused by frequent and multiple laser irradiation on melanocytes, a decrease in melanogenesis, and atrophy of melanocyte dendrites.…”

“…This variable process usually takes about 3 months. 22 Research shows that tattoo pigments enter macrophages 1 week after laser treatment in animal models and that the total amount of pigment in macrophages decreased significantly 1 month later. 23 We also observed lesion recovery by the HFQS 755-nm laser treatment, in which the efficacy was maintained in a relatively stable range with a slight decrease.…”

“…After HFQS 755-nm laser treatment, 65% of patients (n = 13) experienced temporary hypigmentation, and the average remission time was 8 weeks (range 2−12 weeks), more than in previous studies (0%−2.44%). 3,22 Follow-up visits may not have been frequent enough in previous studies, resulting in a lack of relevant records. 3,22 In our study, one patient (5%) experienced persistent mottled hypopigmentation after LFQS 1064-nm laser treatment.…”