▶ Previous Artlcle: #5-3. Laser in Clinical Medicine 

 

Skin Lesions and Characteristics

 

Skin pigmented lesions can be divided intoepidermal melanocytic lesions and dermal melanocytic lesions, and there are other benign lesions.

 

Epidermal melanocytic lesions

 

Epidermal melanocytic lesions include freckles, Café au lait macules, Becker’s nevus, nevus spilus, and lentigines.

 

1) Freckles 

 

Freckles are autosomal dominant hereditary pigmented lesions that occur after 5 years of age, and appear as small, irregular brown spots less than 5-6 mm. It deteriorates when exposed to UV rays.

 

In terms of histological characteristics, the number of melanocytes is normal, but melanocyte activity is increased, resulting in increased melanin secretion and increased melanosomes in the basal layer.

 

It can be treated by using 532nm Q switched Nd:YAG laser, Q switched Ruby laser, long pulsed Alexandrite laser, and Q switched Alexandrite laser, which are used for treatment of superficial pigmented lesions.

 

In addition, it can also be effectively treated with IPL. Freckle lesions recur after 1-2 years of treatment. The more the UV exposure, the faster it recurs.

 

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2) Café au lait macules 

 

Usually, café au lait macules occur at birth or shortly after birth, and milk coffee color spots can develop anywhere in the body, including the face. If six or more milk coffee spots with a diameter of 15mm or more are observed, neurofibromatosis should be discriminated.

 

In terms of histological characteristics, normal or slightly increased melanocyte count is shown in the epidermis, melanocyte activity is increased, resulting in increased melanin secretion and increased melanosomes, and macromelanosomes are observed.

 

It can be treated by using 532nm Q switched Nd:YAG laser, Q switched Ruby laser, long pulsed Alexandrite laser, and Q switched Alexandrite laser. In recent years, laser toning has been reported to be effective in treating café au lait macules. However, based on my experience, it is a pigmented lesiondifficult to treat compared to freckles.

 

There are many cases of recurrence soon after laser treatment, and in many cases,it cannot be said that recurrence does not occur at all, although the recurrence rate decreases when laser toning is performed in combination.

 

- To be continued