Efficacy and safety of a topical carbon suspension photoenhancer adjunctive to intense pulsed light treatment for pigmented lesions in Japanese patients: A pilot study.

Abstract

Pigmented lesions, e.g., senile lentigo and seborrheic keratosis are commonly seen in photodamaged skin in the Japanese general population. The use of the laser to treat such lesions is often painful, and intense pulsed light (IPL) systems have become widely used. Clearly demarcated pigmented lesions may be identified easily and treated with IPL. Less well demarcated lesions, however, which are very difficult to identify or thick melanogesic lesions like seborrheic keratosis represent one of the most challenging conditions to be treated using IPL. This pilot study evaluated carbon suspension-assisted IPL treatment of such lesions. Three female Japanese patients, Fitzpatrick skin type III-IV, comprised the subjects, aged 58, 78 and 85, with indistinct senile lentigines or thick seborrheic keratoses. The lesions were painted or demarcated with a carbon-based ink from a commercially-available Japanese writing instrument (Fude-pen™, Pentel, Japan) consisting of a brush-like pen nib with a refillable or replaceable ink reservoir, and then treated with a broadband (560 - 1200 nm) IPL system. The poorly-demarcated lesions were quickly and easily marked with the pen, and the IPL treatments were well-tolerated. All patients had good improvement in their painted pigmented lesions based on the overall evaluation, compared with unpainted ones. Side effects after treatment, such as hyperpigmentation, persistent erythema, and scarring, were minimal. Topical carbon suspension-assisted IPL treatment could be a good option for patients with indistinct pigmented or thick melanogenesic lesions. Adverse reactions to this treatment were minimal and the results acceptable, though appropriate lesions need to be chosen carefully.