The use of 2940-nm ER:YAG laser for the treatment of lentigo maligna.

Abstract

Lentigo maligna is a common in situ malignancy in elderly patients, with a low risk of progression to an invasive tumor. Surgical treatment may be complicated or refused. Non-surgical treatment options (such as lasers) may therefore be needed. We report on 17 patients treated with a 2940-nm Er:YAG (erbium-doped yttrium aluminum) laser for histopathologically confirmed lentigo maligna. The lesions were ablated with a 5mm margin of adjacent skin under local anesthesia with a 3.5mm overlapping spot, energy density of 6.5J/cm2 and a repetition rate of 5Hz. If clinically visible pigmentation was seen in the ablated area during the following three months, the lesion was re-treated. All patients were followed up for residual or recurrent tumors. We achieved clinical clearance in all 17 patients. There were three recurrences during the follow-up period (9, 30 and 36 months after laser therapy). All patients were satisfied with the treatment course and cosmetic outcome. The mean follow-up duration was 28 months. Laser ablation is an interesting alternative method for treatment of lentigo maligna. It can be used for selected cases where surgery is contraindicated, complicated or declined by the patient.