Abstract

Abstract: Congenital melanocytic nevi (CMN) even small-sized as well as acquired melanocytic nevi (AMN) are of common cosmetic concerns and getting rid of them remain challenging. The aim of this study is to evaluate the efficacy and safety of the ultra-pulsed CO2 laser for the treatment of melanocytic nevi. 15 male and female Libyan patients with 16 AMN and 7 CMN were treated with multiple sessions of ultra-pulsed CO2 laser at 1-month intervals. Clinical response at 6 months after final treatment was graded as poor (< 50%), moderate (50–75%), good (> 75%) and excellent where the skin of the lesion returned normal as the rest of the surrounding skin. All treated nevi showed good to excellent cosmetic outcomes after 2 or 4 treatment sessions. The post laser complication were minimal and transit except for one atrophic scar. No recurrence of pigmentation during the six months of follow-up period. Conclusion: Ultra-pulsed CO2 laser seems to be effective and associate with minimum adverse side effect in the treatment of small CMN and AMN.

Highlights

  • Melanocytic nevi may present at birth in about 1% - 6% of newborn infants and referred as congenital melanocytic nevi (CMN) or may developed later on in life where known as acquired melanocytic nevi (AMN) [1, 2]

  • Depending on the clinical examination solely, sometimes it is hardly possible to differentiate between congenital and acquired nevi and documentation since birth may be the only way to prove the congenital origin [3]

  • Congenital melanocytic nevi classified according to their surface areas into; small CMN with a diameter 19.5cm [2,4]

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Summary

Introduction

Melanocytic nevi may present at birth in about 1% - 6% of newborn infants and referred as congenital melanocytic nevi (CMN) or may developed later on in life where known as acquired melanocytic nevi (AMN) [1, 2]. Different modality of treatment were tried to treat melanocytic nevi including; surgical excision, cryotherapy, dermabrasion, curettage and chemical peeling. Some of these modality of treatment is effective in removing the nevi but the risk of dyschromia and scar formation limit their uses. Nevi in esthetically sensitive or surgically challenging areas and large nevi is another important obstacle. In these conditions laser treatment of melanocytic nevi is the appropriate alternative choice [5, 6]. Both pigment-specific alexandrite (Al, 755 nm), neodymium: yttrium aluminum-garnet (Nd:YAG,1064 nm ) and frequency-doubled Nd:YAG laser ( fd Nd:YAG, 532 nm) and ablating lasers such as carbon dioxide (CO2) and erbium: yttrium– aluminum–garnet (Er:YAG) and in combination with each other, have been found to be effective in the treatment of melanocytic nevi but with variable outcome and sequels [5,6,7,8]

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