Laser CO2 continu dans le traitement des hamartomes épidermiques verruqueux

Abstract

Verrucous epidermal nevus are benign epidermal hyperplasias. Their treatments are disappointing because of recurrences and anaesthetic scars. The aim of this study was to evaluate the efficacy of continuous carbon dioxide laser in the treatment of verrucous epidermal nevus. It was a retrospective study concerning all patients treated for epidermal verrucous nevus by carbon dioxide laser from 1991 to 2003. Several criteria were evaluated by the patients, a dermatologist and a staff (external observers). Aesthetic result, recurrences, pain due to treatment and global result were evaluated by the patients when they came back. Twenty-one patients (12 F and 9 M), medium age 20.4, were evaluated with a 40.4 months follow-up (7 to 165 months). The epidermal verrucous nevus was situated on the neck or on the head for 62% of them (n = 13). Among these 21 patients, 86% (n = 19) estimated their skin as "cured" or "nearly normal" or "much improved". The rate was the same for the dermatologist. As for the staff, thanks to photos, only 53% of results were satisfying. The recurrences were never complete, but moderate in 38% of patients. Five patients, medium age 12,5, had hypertrophic scars. Among them, three were only partially hypertrophic. A literature review has been made. Our satisfaction rates (nearly 90%) were slightly higher than other studies rates using carbon dioxide laser (74%) or other types of lasers (87%). The medium follow-up was longer than the one of other laser CO2 studies (26.7 months) or other lasers studies' (15.8 months). This study shows that continuous wave carbon dioxide laser is an easy and effective treatment of verrucous epidermal nevus. Aesthetic results are satisfying but moderate recurrences often occur. To prevent hypertrophic scars, we suggest to exclude teenagers.