engleski

Laser treatment of pigmented lesions. When?

Laser therapy is commonly treatment of choice for a variety of epidermal and dermal pigmented lesions, as they are often removed for cosmetic reasons. Several pigment-specific laser systems have been employed for removal of pigmented lesions today, including pigmented lesion pulsed dye laser (510 nm), the Q-switched ruby laser (694 nm), the Q-switched alexandrite laser (755 nm) and the Q-switched Nd:YAG laser (1064 nm), which can be frequency-doubled to produce visible green light with a wavelength of 532 nm. The main advantage of laser therapy is selective destroyment of pigment-containing tissue with excellent cosmetic results. However, therapeutic results are not always favourable. In general, solar lentigines and some dermal melanocytic lesions improve significantly or clear completely, while café au lait macules, postinflammatory hyperpigmentations and melasma respond variably to laser treatment. The treatment failures may occur owning to dermal pigment remaining at greater tissue depths than the laser can reach. Even after complete removal of lesion, repigmentation can develop from stimulated melanocytes within adnexal epithelium. The essential question in removing pigmented lesions with lasers is whether the lesion has atypical features or has a malignant potential. Dermoscopy, used as a routine first-level diagnostic technique, is helpful in most cases. However, if there is any doubt whether the lesion is benign, then a biopsy for histological evaluation is obligatory.

epidermal and dermal pigmented lesions; pulsed dye laser; Q-switched ruby laser; malignant potential

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