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Treatment of Benign and Atypical Nevi With the Normal-Mode Ruby Laser and the Q-Switched Ruby Laser
Clinical Improvement but Failure to Completely Eliminate Nevomelanocytes
Daniella Duke, MD, MPH;
H. Randolph Byers, MD, PhD;
Arthur J. Sober, MD;
R. Rox Anderson, MD;
Joop M. Grevelink, MD, PhD
Arch Dermatol. 1999;135:290-296.
Objective To evaluate the effect of normal-mode and Q-switched ruby laser light (694 nm) on nevomelanocytes of benign, atypical, and congenital nevi.
Design Half of the lesion of each of 31 nevi was treated with either the Q-switched ruby laser or the normal-mode ruby laser or both; the other half of the lesion was covered with aluminum foil and was not treated.
Setting A university-affiliated, hospital-based laser center.
Patients Sixteen patients with a total of 31 melanocytic nevi were enrolled in the study.
Interventions All nevi were evaluated by at least 2 dermatologists to assess the degree of clinical atypia. Photographs were taken before and immediately after treatment and at each follow-up visit. The digital imaging system was used to evaluate the number of melanocytes in a measured length of basement membrane zone.
Main Outcome Measure Three individual readings (number of melanocytes per unit length) were taken on both the control and treated halves and then compared to quantitate treatment effect. All analyses used averages from 3 measurements. A Student paired t test was used to compare the treated and untreated sides.
Results Sixteen (52%) of the nevi showed a clinically visible decrease in pigment on the treatment side at the 4-week follow-up visit.
Conclusion No lesions had complete histologic removal of all nevomelanocytes. Therefore, 1 or 2 laser treatments are not sufficient to cause complete removal of a lesion either clinically or histologically.
From the Dermatology Laser Center (Drs Duke, Anderson, and Grevelink) and Department of Dermatology (Dr Sober), Massachusetts General Hospital, Harvard Medical School, Boston; Dermatopathology Section, Department of Dermatology, Boston University School of Medicine (Dr Byers); Department of Dermatology, Yale Medical School, New Haven, Conn (Dr Duke); and Eastern Connecticut Dermatology, Groton (Dr Duke).
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