Bilateral Nevus Of Ota-like Macules Research Articles

High-fluence 1064nm Q-switched Nd:YAG laser treatment for ectopic Mongolian spot

Q-switched neodymium-yttrium aluminum-garnet (Q-switched Nd:YAG) laser has been reported as an effective treatment for nevus of Ota and acquired bilateral nevus of Ota-like macules (ABNOM). Data on ectopic Mongolian spots have rarely been reported.The present study was performed to investigate the treatment efficacy of a high-fluence 1064 nm Q-switched Nd:YAG laser without tissue whitening in ectopic Mongolian spots.We included 61 patients with ectopic Mongolian spots, and 70 lesions were examined. Thirty-three lesions were treated with a high-fluence 1064 nm Q-switched Nd:YAG laser, and 38 lesions were observed without treatment. The results were assessed using a 5-quantile grading scale and melanin index using a Mexameter®.Mean follow-up duration was 14.1 ± 6.8 months for the treatment group and 17.8 ± 10.0 months for the observation group. Mean 5-quintile grading scale at final follow-up was statistically different (p < 0.001) between the two groups (treatment: 2.85 ± 1.00, observation: 0.49 ± 0.73). There was a significant difference (p < 0.001) in the Δ melanin index (initial melanin index – final melanin index) between the observation (7.1 ± 62.7) and treatment (156.7 ± 78.4) groups.High-fluence Q-switched Nd:YAG laser without tissue whitening showed good results and was well-tolerated in treating ectopic Mongolian spots.

Application of Picosecond Laser in Dermatology

ABSTRACT Background: Lasers are one of the most important treatment modalities in dermatology. Lasers interact with chromophores through several mechanisms that depend on fluence and pulse durations. Early lasers worked by photothermal interaction with pulse durations of 1 microsecond to 1 second. A picosecond laser is developed to confine photothermal effects and produce photomechanical effects and plasma induction. Purpose: To understand the mechanism of action and application of picosecond lasers for dermatological disorders. Review: Non-fractional picosecond lasers work by photomechanical interaction. Photomechanical interaction happens when pulse duration is less than inertial confinement time, causing fractures of chromophores with lower energy, or “cold ablation”. Fractional picosecond lasers work by laser-induced optical breakdown (LIOB). In LIOB, accelerated seed electrons cause an electron avalanche that produce a collection of free electrons called plasma, which ablates tissues. LIOB in the skin is always followed by photodisruption. In LIOB, vacuoles and debris were eliminated transdermally and dermal collagen and elastin increased. Picosecond laser may be applied in disorders requiring destruction of chromophores and for collagen and elastin disorders. It is currently the first-line treatment for tattoo removal (Nevus of Ota and Acquired Bilateral Nevus of Ota-like macules, or ABNOM). It has good efficacy and safety for solar lentigines, freckles, and cafe-au-lait macules (CALM). It is an additional treatment for moderate to severe melasma and hypertrophic scars, in combination with other treatments. The fractional picosecond laser showed moderate improvement and low risk of postinflammatory hyperpigmentation (PIH) for atrophic acne scars and produced improvement in striae alba.

Acquired, bilateral nevus of Ota-like macules in children: Clinical findings in 46 patients

Acquired, bilateral nevus of Ota-like macules in children: Clinical findings in 46 patients

A retrospective study of 1064-nm Q-switched Nd:YAG laser therapy for acquired bilateral nevus of Ota-like macules.

The therapeutic efficacy of laser treatments for acquired bilateral nevus of Ota-like macules (ABNOM) varies among studies, and few studies have evaluated the factors affecting therapeutic effects. To evaluate the efficacy and safety of 1064-nm Q-switched Nd:YAG laser (QSNYL) therapy for ABNOM and to identify the factors influencing the outcome. A total of 110 patients with ABNOM were retrospectively evaluated and received two-to-nine treatment sessions. The effects of different factors on the therapeutic effect were analyzed on the basis of the number of treatments, age at first treatment, skin type, lesion color, affected area, number of lesion sites, and presence of concomitant melasma. The curative effect was positively correlated with the treatment time and negatively correlated with the increasing age at first treatment (p<0.05). The curative effect was better in patients with skin type III than those with type IV ( p<0.05) and in patients with a lesion area of less than 10cm2 than those with a larger affected area (p<0.05). Additionally, the treatment effect was poorer in patients with concomitant melasma (p<0.05). The treatment effect was not significantly correlated with the lesion color or number of affected sites (p>0.05). Eleven patients (10%) developed postinflammatory hyperpigmentation (PIH). Early and repeated QSNYL therapy achieved satisfactory results for ABNOM. The risk of PIH after laser treatment is highest among patients with older age, darker lesion color, and darker skin color. For patients with ABNOM with concurrent melasma, low-energy laser therapy is recommended to reduce the risk of melasma aggravation.

Long-Term Follow-up for 1,064-nm Nanosecond and Picosecond Laser Treatment of Acquired Bilateral Nevus of Ota-Like Macules.

Long-Term Follow-up for 1,064-nm Nanosecond and Picosecond Laser Treatment of Acquired Bilateral Nevus of Ota-Like Macules.

Skin diseases in Asian individuals that you do not want to miss: A selection of unique or relatively more common conditions in Asian populations

The Asian population currently constitutes a simple majority of the global population, comprising nearly 60%. The percentage of the US population that identifies as Asian is expected to grow to 41 million by the year 2050, making up an eventual 9% of the US population. As the world and US populations of Asian individuals increase, the demand for dermatologic care from this population will increase, requiring dermatologists to become more familiar with the diagnosis and treatment of Asian-specific skin characteristics and diseases. In this contribution, we review skin conditions specific to or relatively more common in Asian patients to help recognition and management of diseases in an increasing Asian patient population. We discuss prurigo pigmentosa, primary cutaneous plasmacytosis, lipodystrophia centrifugalis abdominalis infantilis, Epstein-Barr viru–positive T- and natural killer-cell lymphoproliferative disorders, acquired bilateral nevus of Ota-like macules, and Behҫet disease.

Imatinib Mesylate-Induced Acquired Dermal Melanocytosis and Acquired Bilateral Nevus of Ota-Like Macules

Imatinib Mesylate-Induced Acquired Dermal Melanocytosis and Acquired Bilateral Nevus of Ota-Like Macules

Symmetric facial macules in an Asian woman

Hori nevus, also known as acquired bilateral nevus of Ota-like macules, is a form of dermal melanocytosis found most commonly in women of East Asian heritage. It presents as discrete brown macules on the bilateral cheeks which later coalesce into confluent grey-brown macules and small patches. Herein, we report a classic case of Hori nevus and discuss the histologic findings and differential diagnosis. We also review the proposed pathophysiology, genetic considerations, and treatment options.

Laser treatment of pigmentation disorders

Pigmentation disorders are among the most common cutaneous changes and occur in up to 60% of all people. They can be genetic or acquired, functionally or cosmetically disturbing, or the expression of a medical disorder. The best treatment options for hyperpigmentation are usually lasers and intense pulsed light (IPL). However, they can also worsen some conditions and are occasionally associated with side effects. A correct diagnosis is therefore essential, taking into account the skin type, the type of pigmentation and how deep the pigmentation is located in the skin. The most common indications for which laser treatment is recommended include genetically predisposed nevi (Becker, Ota, Hora, Ito, acquired bilateral nevus of Ota-like macules [ABNOM]), pigmentation (e.g., lentigines, postinflammatory hyperpigmentation, ephelides, café au lait, nevus spilus, linear and whorled hypermelanosis [LWNH]), nevus cell nevi, exogenous pigments, tattoos and cosmetic pigments.

Efficacy and safety of the picosecond 755-nm alexandrite laser for treatment of dermal pigmentation in Asians-a retrospective study.

Q-Switched laser devices have been a standard treatment modality for dermal pigmentary disorders since the 1990s. However, the adverse events are sometimes intolerable even if the efficacy has been well accepted. These adverse events stop the patient from continuing the treatment and cause other cosmetic issues. Since 2012, the first picosecond laser for cosmetic applications was approved; it seems promising for treating pigmentary disorders in a new way, but lack strong evidence. We evaluated the efficacy and safety of a 755-nm picosecond laser for treatment of dermal pigmentary disorders in Asians. This is a 2-year retrospective study. We reviewed 36 female cases, including 8 cases of nevus of Ota and 28 cases of acquired bilateral nevus of Ota-like macules. Institutional Review Board (IRB) approval was granted by the Chang Gung Memorial Hospital medical research ethics committee (IRB 201900833B0). The epidemiologic data was collected. These patients have been treated with the 755-nm picosecond laser for 1 to 4 sessions at variable treatment interval. Our parameter settings were fluence of 2.73-3.98J/cm2, with a spot size of 2.9 to 2.4mm under the 650-ps mode. The pulse duration is 650ps and fluence range is from 2.73 to 3.98J/cm. Photographs were taken prior to every treatment and 1month following the treatment. Two dermatologists conducted the clinical evaluation independently. Clinical improvement was observed in all with a minimal side effect. A total of 88.89% of patients had moderate to marked improvement in following 1 to 4 sessions. Transient swelling and erythema were observed in all patients but resolved within 24h. Only one patient (2.78%) developed hypopigmentation and two patients (5.56%) had hyperpigmentation temporarily. Faster clearance could be achieved by the picosecond 755-nm laser for treating dermal pigmentary disorders in Asians. The treatment course is well tolerable and has minimal side effects.

In vivo reflectance confocal microscopy for evaluating common facial hyperpigmentation.

In clinical settings, atypical facial hyperpigmentation such as nevus of Ota, acquired bilateral nevus of Ota-like macules (ABNOM), melasma, and café-au-lait spots are often missed and misdiagnosed. Summarizing in vivo reflectance confocal microscopy (RCM) features of the hyperpigmentation is helpful in the diagnosis of ambiguous lesions. We recruited 196 patients referred for unequivocal facial hyperpigmentation, including 55 patients with nevus of Ota, 45 patients with ABNOM, 62 patients with melasma, and 34 patients with café-au-lait spots. The RCM images were evaluated at the epidermis, the dermis-epidermis junction (DEJ), and the upper papillary dermis from both hyperpigmented patches and normal skin. In the superficial and middle dermis, 41 of 55 patients (74.5%) with nevus of Ota were characterized by a cord-like or lumpy structure between the collagen fibers. And there was no melanin deposition detected in the dermis in 14 of 55 (25.5%) patients. In ABNOM, 37 of 45 (82.2%) patients were characterized by a cord-like or lumpy structure in the superficial dermis and 8 of 45 patients (17.8%) was no melanin deposition detected in the dermis. The epidermis was no difference between nevus of Ota, ABNOM, and the normal skin. Melasma was detected increased cobblestone pattern in the epidermis of all patients, branching architecture in 21 of 62 patients (33.9%), and focally aggregated round to triangular cells in the upper dermis of 18 of 62 patients (29.0%). In all patients with afé-au-lait spots, increased cobblestone pattern in the epidermis and regular and increased density of ringed pattern in the DEJ were visualized. Our findings indicate that RCM may be useful in the auxiliary diagnosis of nevus of Ota, ABNOM, melasma, and café-au-lait spots.

Effects of Q-Switched Laser Treatments on Acquired Bilateral Nevus of Ota-Like Macules: A Retrospective Comparative Study

Abstract Objective: Q-switched lasers, including 1064-nm Nd:YAG nanosecond laser (QSNYL), 755-nm alexandrite nanosecond laser (QSAL), and 694-nm nanosecond ruby laser (QSRL), are clinically available for the treatment of acquired bilateral nevus of Ota-like macules (ABNOM). However, no reliable evidence from large-scale comparative studies identifies which type of laser works best. This study aims to determine the differences in the effectiveness, complications, and risk factors of QSNYL, QSAL, and QSRL in the treatment of ABNOM, further to provide evidence for clinician to make optimal choice according to the condition of patients. Methods: We collected the data from 685 ABNOM patients, including clinical features, medical treatments, and follow-up, since 1999 to 2014. The Kruskal–Wallis test was used to compare therapeutic differences between the three groups. The risk factors were analyzed using univariate analysis (χ 2 test) and multivariate logistic regression analysis. Results: The overall treatment efficiency of the QSNYL group (52.5%) and QSAL group (51.9%) was higher than that of the QSRL group (39.5%) (χ 2 = 17.468, P &lt; 0.001). The onset time of the QSRL and QSAL groups was shorter than that of the QSNYL group. The factors influencing efficacy in the QSNYL group were age at first treatment, number of treatments, coexistence with melasma, and the presence of hyperpigmentation; in the QSAL group was the number of treatments; and in the QSRL group was the number of treatments and hyperpigmentation. The prevalence of hyperpigmentation in the QSNYL group (30.5%) and the QSAL group (27.5%) was lower than that of the QSRL group (47.3%) (χ 2 = 6.576, P &lt; 0.001). Conclusion: The QSNYL, QSAL, and QSRL are all effective and safe treatments for ABNOM. Considering the overall efficacy, duration of treatment, side effects, and risk factors, the QSAL is an optimal choice for ABNOM treatment.

The Efficacy of a Q-Switched 694-nm Ruby Fractional Laser for Treating Acquired Bilateral Nevus of Ota-Like Macules

The Efficacy of a Q-Switched 694-nm Ruby Fractional Laser for Treating Acquired Bilateral Nevus of Ota-Like Macules

A split-face, single-blinded, randomized controlled comparison of alexandrite 755-nm picosecond laser versus alexandrite 755-nm nanosecond laser in the treatment of acquired bilateral nevus of Ota–like macules

Q-switched alexandrite lasers (QSALs) have been used for the treatment of acquired bilateral nevus of Ota-like macules (ABNOMs). Currently, picosecond alexandrite laser (PSAL) pulses have become available for pigmentary disorders. However, no studies have compared PSAL and QSAL in the treatment of ABNOM. We sought to compare the efficacy and safety of PSAL and QSAL in the treatment of ABNOM. Each patient (n=30) received 3 treatments at 6-month intervals. Matching areas were delimitated on the face of each patient (left/right comparison); 1 side was treated with PSAL and the other side was treated with QSAL. The safety and efficacy of the 2 lasers were determined by visual assessment and self-report from patients 6months after the final treatment. The PSAL-treated area achieved significantly better clearance (3.73 vs 2.4) with less severe pain (4.47 vs 5.16). The incidence rate of postinflammatory hyperpigmentation was 27.77% and 54.44% for the PSAL and QSAL treatments, respectively, and the duration of postinflammatory hyperpigmentation was 1.32 and 1.74months, respectively (P<.001). The limitations of our study include the small sample size and the lack of objective evaluation. Compared with QSAL, PSAL therapy afforded significantly better clinical outcomes andfewerside effects in the treatment of ABNOM.

Clinical profile and triggering factors for acquired, bilateral nevus of Ota-like macules

Background: Acquired, bilateral nevus of Ota-like macules (ABNOM) is one of the most common dermal melanocytoses. Although there are some literatures on ABNOM, its clinical features and etiopathogenetic factors have not been fully understood.Objective: To determine the prevalence and characteristics of ABNOM among the Chinese patients.Methods: A survey was carried out using the clinical examination and a questionnaire on 3212 first-time outpatients in our dermatology department, and 102 cases of ABNOM were subsequently enrolled.Results: The outpatient prevalence of ABNOM was 3.18%, and the age of the onset was 27.2 years on average. They all presented as speckled macules on the face alone or coexisted with patchy lesions (17.7%) or a band-like pigmentation (1.0%). Unprecedentedly, we found the zygomatic arch, the infraorbital, the cheek and the parotid region can be involved, and 52.0% cases had sclera pigmentation. ABNOM commonly coexisted with the pigmented fungiform papillae of the tongue, the melasma, the acne, prementstrual syndrome (female) and breast cystic hyperplasia (female) with the rates of 33.3%, 20.6%, 26.5%, 47.0% and 43.0% separately. Triggering factors’ investigation disclosed screen irradiation (47.1%), pregnancy (32.0%), cosmetics (29.4%), sensitive skin (22.6%), and positive family histories (21.6%) were highly related.Conclusions: Our study confirms that ABNOM is a relatively common disorder among adult Chinese’s outpatients. It is commonly distributed over the malar, lateral forehead and temple’s areas. The sclera pigmentation is another common finding that is overlooked in previous research. ABNOM is concomitant with melasma and some other disorders. Excessive sun exposure, hormonal disturbances and hereditary susceptibility are the main potential triggering factors of ABNOM.

The Treatment of Pigmented Lesions in Taiwan

Combined dyspigmentation such as lentigines intermingled with freckles, or melasma with acquired bilateral nevus of Ota-like macules, are common among women in Taiwan. There are various lasers available, including Qswitched Nd-YAG laser, Q-switched alexandrite laser, Q-switched ruby laser, and pico laser. We conducted a literature review to understand the current practice of treatment for pigmented lesions in Taiwan.

Improvement in Acquired Bilateral nevus of ota-Like Macules with Picosecond-Domain Wavelength-converted 595-nm neodymium:Yttrium Aluminium Garnet Laser Treatment

The acquired bilateral nevus of Ota-like macules (ABNOM) is a common dermal pigmentary condition in Asians. Histologically, these lesions are similar to the nevus of Ota. However, ABNOM lesions differ in that melanocytes are located more superficially and clustered perivascularly. To treat ABNOM, various pigment-targeting Q-switched lasers have been used, although the treatment of ABNOM is more difficult than that of nevus of Ota. In this current report, we treated a patient with refractory ABNOM by targeting vessels in ABNOM lesions using a picosecond-domain wavelength-converted 595-nm neodymium:yttrium aluminium garnet (Nd:YAG) laser. The patient showed clinical improvement in underlying vascular components and ABNOM lesions after two sessions of combined treatment with picosecond-domain 1,064-nm and wavelength-converted 595-nm Nd:YAG lasers. Accordingly, we suggest that a similar treatment may be promising as a therapeutic method for treating ABNOM.

Induction of melasma by 1064-nm Q-switched neodymium:yttrium-aluminum-garnet laser therapy for acquired bilateral nevus of Ota-like macules (Hori nevus): A study on related factors in the Chinese population.

Laser treatment has emerged as a common treatment modality for acquired bilateral nevus of Ota-like macules (ABNOM). To identify the ratio of melasma induction and exacerbation before and after laser therapy for ABNOM and to observe the risk factors related to the induction and exacerbation of melasma by laser therapy, we analyzed related factors of 1268 adult Chinese patients who underwent 1064-nm Q-switched neodymium:yttrium-aluminum-garnet (Nd:YAG) laser (QNYL) treatment using case series and case-control studies. Overall, 24.0% of the ABNOM patients had mixed melasma. Among the ABNOM patients without melasma, after laser therapy the development of melasma was more frequently noted in patients older than 35 years (P < 0.0001), as well in patients whose ABNOM was less than 10 cm(2) (P = 0.027), ABNOM were light (similar to yellow-brown) in color (P = 0.021) and skin types were closer to type IV (P < 0.0001). New melasma lesions also appeared most frequently in the zygomatic region (P < 0.0001). Among the ABNOM patients with melasma, 89.5% experienced worsening of their melasma, irrespective of their related factors above. We concluded that the risk of inducing melasma is great after 1064-nm QNYL treatment in ABNOM patients, and particularly in the patients with both ABNOM and melasma. ABNOM patients should be treated as early as possible and before the age of 35 years.

Acquired bilateral nevus of Ota-like macules (Hori’s nevus): A case report and treatment update

Acquired bilateral nevus of Ota-like macules (Hori’s nevus): A case report and treatment update

Acquired Bilateral Nevus of ota-like Macules with Mucosal Involvement: A New Variant of Hori's Nevus.

Acquired bilateral nevus of Ota-like macules (ABNOM) or Hori's nevus, a rare form of acquired dermal melanocytoses, presents as bilateral facial blue-gray macules without ocular or mucosal involvement. This condition is mostly found in women of Asian descent and usually appears in the fourth or fifth decade of life. Pathogenesis is unknown, though few theories have been proposed. Effective treatment has been found to be achieved with pigment-specific lasers. Herein, we report a case of Hori's nevus with mucosal involvement. A 42-year-old male patient, presented to us with blue-gray discoloration on either side of his face, both eyes, and in the mouth since the age of one year. Histopathological examination showed clusters and singly dispersed pigmented melanocytes within the upper and mid-dermis regions. Special staining of melanocytes using Masson-Fontana stain was positive. Diagnosis of Hori's nevus was made by correlating clinical and histopathological findings. Patient was informed of his treatment options, but refused treatment. A similar case of Hori's nevus with mucosal involvement has not been reported so far.