• #1-1. Dermal melanocytic lesions

     

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    Dermal melanocytic lesions include Mongolian spot, Ota nevus, ABNOM(Acquired Bilateral Nevus of Ota like Macules), Ito nevus, and Blue nevus.

     

    Mongolian spot

     

    Mongolian spot is the most common dermal melanocytic lesion, which is a circular or elliptical blue or bluish gray spot with an unclear boundary.

     

    It is present at birth and is mostly lost around 7 years of age, so no special treatment is required.

     

    Histologically, melanocytes are observed in the dermis, and melanin is widely distributed along the collagen layer in the central and lower dermis.

     

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    Ota Nevus 

     

    Ota nevus is a gray brown, blue gray or blue black spotcaused by dermal melanocytes around the skin of eyes, temple, forehead, cheekbone, and nose where the first and second branches of trigeminal nerve are distributed, as well as ocular sclera.

     

    It develops from birth to 10 years of age and becomes wider and darker in childhood, but rarely occurs after 20 years of age.

     

    It involves eyes in 2/3 of cases. It is mostly observed to be unilateral, but it is observed to be bilateral at approximately 10%.

     

    Thus, checking whether pigmented lesions are observed in oral mucosa or ocular sclerain the medical history and physical examination and whether graybrown, bluegray, and blue black dermal pigmented lesions are observed around thetrigeminal nervebranchesis an important point in distinguishing from ABNOM.

     

    Histologically, melanocytes are increased in the dermis and melanosomes are increased in the melanocytes.

     

    It can be treated by using 1064nm Q-switched Nd:YAG laser, Q-switched Ruby laser, and Q-switched Alexandrite laser. Recently, 1064nm picosecond laser can be used for treatment.

     

    It can also be treated by repetitive high fluence laser toning or focus toning to improve gradually while reducing the duration of recovery.

     

    - To be continued

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