Lasers in Medical Science

, Volume 33, Issue 3, pp 597–601 | Cite as

Picosecond 532-nm neodymium-doped yttrium aluminum garnet laser—a promising modality for the management of verrucous epidermal nevi

  • Assi Levi
  • Dan Ben Amitai
  • Daniel Mimouni
  • Yael A. Leshem
  • Ofir Arzi
  • Moshe Lapidoth
Original Article
  • 110 Downloads

Abstract

The verrucous epidermal nevus (VEN) is the most common type of epidermal nevi. As lesions can be disfiguring, treatment is often sought. Many therapeutic approaches have been reported, with variable efficacy and safety. Picosecond (PS) lasers are novel laser devices designated to target small chromophores. A side effect of these lasers is blistering due to epidermal-dermal separation. We aimed to harness this side effect of the PS lasers to treat patients with VEN. The purpose of this study was to report our experience treating VEN using a PS 532-nm laser. We present a retrospective case series of six patients with large VEN who were treated using a PS 532-nm laser (2–6 treatments, 8–10 weeks apart). Response in clinical photographs was assessed by two independent dermatologists and graded on a scale of 0 (exacerbation) to 4 (76–100% improvement). Patient satisfaction was recorded on a scale of 1–5. All patients demonstrated significant improvement. Average improvement was 3.7 on the quartile scale of improvement. Patient satisfaction rate averaged 4.7. The PS 532-nm laser is a promising novel modality for the treatment of large VEN.

Keywords

Epidermal nevus Verrucous epidermal nevus Laser treatment Picosecond 532-nm laser Dermal-epidermal separation Esthetic improvement 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Sugarman JL (2007) Epidermal nevus syndromes. Semin Cutan Med Surg 26:221–230CrossRefPubMedGoogle Scholar
  2. 2.
    Ruggieri M, Praticò AD (2015) Mosaic neurocutaneous disorders and their causes. Semin Pediatr Neurol 22(4):207–233CrossRefPubMedGoogle Scholar
  3. 3.
    Igawa S, Honma M, Minami-Hori M, Tsuchida E, Iizuka H, Ishida-Yamamoto A (2016) Novel postzygotic KRAS mutation in a Japanese case of epidermal nevus syndrome presenting with two distinct clinical features, keratinocytic epidermal nevi and sebaceous nevi. J Dermatol 43:103–104CrossRefPubMedGoogle Scholar
  4. 4.
    Miranda LQ, Fracaroli TS, Fonseca JC, Fontenelle E, Curvo RP, Porto LC, Souto R (2013) Analysis of mutations in the PIK3CA and FGFR3 genes in verrucous epidermal nevus. An Bras Dermatol 88(6 Suppl 1):36–38CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Brandling-Bennett HA, Morel KD (2010) Epidermal nevi. Pediatr Clin N Am 57:1177–1198CrossRefGoogle Scholar
  6. 6.
    Lee BJ, Mancini AJ, Renucci J, Paller AS, Bauer BS (2001) Full-thickness surgical excision for the treatment of inflammatory linear verrucous epidermal nevus. Ann Plast Surg 47(3):285–292CrossRefPubMedGoogle Scholar
  7. 7.
    Toyozawa S, Yamamoto Y, Kaminaka C, Kishioka A, Yonei N, Furukawa F (2010) Successful treatment with trichloroacetic acid peeling for inflammatory linear verrucous epidermal nevus. J Dermatol 37:384–386CrossRefPubMedGoogle Scholar
  8. 8.
    Mutasim DF (2006) Successful treatment of inflammatory linear verrucous epidermal nevus with tacrolimus and fluocinonide. J Cutan Med Surg 10:45–47CrossRefPubMedGoogle Scholar
  9. 9.
    Kim JJ, Chang MW, Shwayder T (2000) Topical tretinoin and 5-fluorouracil in the treatment of linear verrucous epidermal nevus. J Am Acad Dermatol 43:129–132CrossRefPubMedGoogle Scholar
  10. 10.
    Boyce S, Alster TS (2002) CO2 laser treatment of epidermal nevi: long-term success. Dermatol Surg 28:611PubMedGoogle Scholar
  11. 11.
    Hohenleutner U, Landthaler M (1993) Laser therapy of verrucous epidermal naevi. Clin Exp Dermatol 18:124–127CrossRefPubMedGoogle Scholar
  12. 12.
    Osman MA, Kassab AN (2016) Carbon dioxide laser versus erbium:YAG laser in treatment of epidermal verrucous nevus: a comparative randomized clinical study. J Dermatolog Treat 13:1–6Google Scholar
  13. 13.
    Hammami Ghorbel H, Lacour JP, Passeron T (2014) Treatment of inflammatory linear verrucous epidermal nevus with 2940 nm erbium fractional laser. J Eur Acad Dermatol Venereol 28(6):824–825CrossRefPubMedGoogle Scholar
  14. 14.
    Panagiotopoulos A et al (2009) Assessment of cryotherapy for the treatment of verrucous epidermal naevi. Acta Derm Venereol 89:292CrossRefPubMedGoogle Scholar
  15. 15.
    Lapidoth M, Israeli H, Ben Amitai D, Halachmi S (2013) Treatment of verrucous epidermal nevus: experience with 71 cases. Dermatology 226:342–346CrossRefPubMedGoogle Scholar
  16. 16.
    Reiter O, Atzmony L, Akerman L, Levi A, Kershenovich R, Lapidoth M, Mimouni D (2016) Picosecond lasers for tattoo removal: a systematic review. Lasers Med Sci 31:1397–1405CrossRefPubMedGoogle Scholar
  17. 17.
    Ho SG, Goh CL (2015) Laser tattoo removal: a clinical update. J Cutan Aesthet Surg 8:9–15CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Fox BJ, Lapins NA (1983) Comparison of treatment modalities for epidermal nevus: a case report and review. J Dermatol Surg Oncol 9:879–885CrossRefPubMedGoogle Scholar
  19. 19.
    Alam M, Arndt KA (2002) A method for pulse carbon dioxide laser treatment of epidermal nevi. J Am Acad Dermatol 46:554–556CrossRefPubMedGoogle Scholar
  20. 20.
    Forbat E, Al-Niaimi F (2016) The use of picosecond lasers beyond tattoos. J Cosmet Laser Ther 18:345–347CrossRefPubMedGoogle Scholar
  21. 21.
    Alonso-Castro L, Boixeda P, Reig I, de Daniel-Rodríguez C, Fleta-Asín B, Jaén-Olasolo P (2012) Carbon dioxide laser treatment of epidermal nevi: response and long-term follow-up. Actas Dermosifiliogr 10310:910–918CrossRefGoogle Scholar
  22. 22.
    Michel JL, Has C, Has V (2001) Resurfacing CO2 laser treatment of linear verrucous epidermal nevus. Eur J Dermatol 11(5):436–439PubMedGoogle Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Photodermatoses Clinic, Laser Unit, Dermatology DepartmentRabin Medical CenterPetach TikvaIsrael
  2. 2.Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Depertment of DermatologyTel Aviv Medical CenterTel AvivIsrael

Personalised recommendations