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March 1996

Treatment of Small and Medium Congenital Nevi With the Q-Switched Ruby Laser

Author Affiliations

From the Laser and Skin Surgery Center of New York (NY). Dr Waldorf was a Mohs, laser, and dermatologic surgery fellow of the Laser and Skin Surgery Center of New York at the time the work was done for the manuscript.

Arch Dermatol. 1996;132(3):301-304. doi:10.1001/archderm.1996.03890270077011

Background:  The Q-switched ruby laser has been used successfully to treat a variety of benign pigmented lesions. In this study, congenital nevi (diameter, ≤5 cm) in 18 prepubertal children were treated with the Q-switched ruby laser.

Observations:  Photographic evaluation revealed an average of 57% clearance of pigmentation in all treated nevi by the fourth treatment session and an average maximum clearance of 76% after approximately eight sessions. Greater than 90% clearance of pigment was attained in five patients. Partial repigmentation was seen in all patients who were followed up after discontinuation of therapy. Findings from histopathologic studies, obtained from one patient, revealed a reduction of nevus cells in the papillary dermis and upper reticular dermis that correlated with clinical lightening. There was no such reduction in the lower reticular dermis. Side effects were limited to transient erythema and hypopigmentation.

Conclusions:  The Q-switched ruby laser effectively lightens and may clear pigmentation and eliminate superficial nevus cells from small and medium congenital nevi safely without scarring. However, these results are not permanent. The Q-switched ruby laser may be a viable alternative for providing cosmetic improvement for unresectable lesions, but it should not be considered definitive treatment. Additional studies are needed to address the long-term results of this therapy.(Arch Dermatol. 1996;132:301-304)

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