Treatment Of Congenital Melanocytic Nevi Research Articles

Surgical Therapy of Congenital Nevi in the First Year of Life-Psychological Impact on Parents.

The birth of a child with a congenital melanocytic nevus (CMN) can lead to distress in the parents. Surgical treatment of CMN can begin in infancy. To provide insight into the perspective of parents of children with CMN regarding their experienced psychological burden and motivation to undergo surgery as well as their satisfaction. Retrospective analysis of patient data of infants (< 1 year of age), who were surgically treated by power stretching for CMN using subcutaneous infiltration anesthesia (SIA) from 01/01/2020 to 08/31/2021. To evaluate the parent's motivation and psychological burden during the surgical treatment of their child, a questionnaire was designed to interview them in a standardized telephone-based interview. Out of 45 interviewed parents, 62.2% indicated "severe" or "very severe" distress at the time of their child's birth. Distress was mostly reduced by information about diagnosis and treatment (n = 34) and treatment-progress (n = 27). Stigmatization was experienced by 35.6% of parents. 84,5% of parents were highly satisfied with early initiation of surgical therapy. 69% felt "very satisfied" or "satisfied" with the outcome of surgery. Motivation for surgical therapy was concern about malignant transformation of the, possible stigmatization of the child due to the nevus, while most of the parents (73.3%) mentioned both. Surgical treatment of CMN by power stretching in SIA in infancy is associated with high levels of satisfaction among the children's parents. Early initiation of surgical therapy and education about the diagnosis can reduce the psychological burden of the parents and can prevent psychosocial problems in affected children.

Cultured epithelial autografts for the treatment of large-to-giant congenital melanocytic nevus in 31 patients.

IntroductionGiant congenital melanocytic nevus (GCMN) is a large melanocytic nevus, and its full-thickness removal is usually difficult due to the lack of skin available for reconstruction. Curettage is an alternative approach in cases of GCMN to remove the superficial dermis above the cleavage plane with a curette in the neonatal period, and its major complications include repigmentation, retarded epithelization, and hypertrophic scar formation. In Japan, the JACE® cultured epidermal autograft (CEA) was approved and covered by public healthcare insurance for the treatment of congenital melanocytic nevus (CMN) that is difficult to treat with conventional methods in 2016. We have used CEA for wounds after curettage in the neonatal period or following ablation after the neonatal period in combination with laser therapies to reduce the above-mentioned complications.MethodsIn this study, we summarized all consecutive CMN patients treated using CEA from December 2016 to April 2019 and evaluated the duration required for epithelialization, incidence of hypertrophic scar, and color change in the target nevus by comparing the L∗ values one year later between the Curettage group, the non-Curettage group with initial treatment or the subsequent group.ResultsNo significant differences were seen in the epithelization period or incidence of hypertrophic scars among the groups, but the color of the target nevus was improved significantly in the Curettage group (p < 0.01) and non-Curettage group with initial treatment (p < 0.01).ConclusionsIn conclusion, CEA seems to accelerate epithelization after curettage or ablation of CMN, and this treatment could improve the color of CMN when applied initially.

A novel subdermal anchoring technique for the effective treatment of congenital melanocytic nevus using de-epithelialized dermal flaps.

BackgroundIn patients with congenital melanocytic nevus (CMN), single-stage removal of large lesions can be difficult because the high tension created by excising and repairing a large lesion may result in scar widening. Herein, we introduce a method to effectively excise lesions while minimizing scarring and compare its outcomes to those of existing surgical methods.MethodsWe compared patients who underwent surgery using the anchoring technique (n=42) or the conventional elliptical technique (n=36). One side of the lesion was removed via en bloc resection up to the superficial fascia. The other side of the lesion was removed via de-epithelialization. The de-epithelialized dermal flap was then fixed by suturing it to the superficial fascia on the opposite side. The length of the lesion’s long axis and amount of scar widening were measured immediately after surgery and at 2, 6, and 12 months postoperatively. At 12 months, patients were assessed using the Patient and Observer Scar Assessment Scale.ResultsThe lesion locations included the face, arms, legs, back, and abdomen. The anchoring method resulted in shorter and smaller scars than the conventional method. There were no cases of postoperative hematoma or wound dehiscence. Significant differences in postoperative scar widening were found in the arm and leg areas (P<0.05).ConclusionsThe anchoring method introduced in this study can provide much better outcomes than the conventional method. The anchoring method is particularly useful for the removal of CMN around the joints or extremities, where the surgical site is subjected to high tension.

Cryocarboxy Surgery for the Treatment of Congenital Melanocytic Nevi of the Face, a New Addition of Simple Treatment for a Troublesome Problem

Congenital melanocytic nevi of the face cause substantial psychological and cosmetic problems in affected patients. The treatment of giant congenital nevi has been a long-standing challenge, but currently, various treatment options, such as cryotherapy, chemical peeling, electrical cautery, laser therapy, and surgery, have been tried for the treatment of congenital melanocytic nevi. In this article, we present our experience and the outcomes of the use of controlled carbon dioxide gas as a cryogen in the treatment of congenital melanocytic nevi. This study included 42 patients with varying sizes of congenital melanocytic nevi seen from January 2014 to April 2019. Cryocarboxy surgery was performed in all cases. The average evaluation score of our patients was excellent in 28 (66.6%) cases, good in 9 (21.4%) cases, satisfactory in 5 (12%) cases, and we had no poor results. Cryocarboxy surgery is a good addition to the armamentarium for the treatment of congenital melanocytic nevi. Carbon dioxide is a cheap, non-explosive, and readily available gas.

Congenital melanocytic nevi.

To update pediatric providers on new developments in our understanding of the clinical presentation, genetics, and systemic risks associated with congenital melanocytic nevi (CMN). CMN are primarily caused by sporadic postzygotic somatic mutations, most frequently in NRAS, and studies of the genetic underpinnings of CMN have demonstrated a diverse array of genetic drivers. The primary complications of large and giant CMN include neurocutaneous melanocytosis and malignant melanoma. Abnormalities in CNS MRI may predict a worse clinical course for patients and increased risk of melanoma. Targeted therapies of the MEK pathway have begun to be studied for the treatment of CMN and prevention of associated complications. Patients with large and giant CMN should be managed by an interdisciplinary care team for the monitoring of dermatologic, neurologic, and psychosocial concerns. Ongoing research is underway to better characterize the genetic drivers of CMN and to better guide development of targeted therapeutics.

Artificial Skin INTEGRA Use in the Treatment of Large Melanocytic Nevi

Melanocytic nevi are congenital, benign, pigmented proliferations. They have high risk of malignancy, most frequently transform to malignant skin melanoma and 70% it occurs in the first life decade. The risk of malignant transformation increases proportionately to their size. The best way to avoid those risks is early and radical excision. In 1996 on the market appeared the Integra™ artificial skin, has made it possible to improve the methods for the elimination of large congenital nevi and significantly reduce the risk of malignant melanoma, at an early age.&#x0D; 2011–2019, in Children’s Hospital, Affiliate of Vilnius University Hospital Santaros Clinics, the Integra™ was used to treat congenital melanocytic nevi in four children. Implantation of the skin substitute Integra™ has been successful for all the patients, the prognosis was good.&#x0D; The treatment of congenital melanocytic nevi is a necessity to avoid the risk of developing malignant melanoma. The rarity of this condition has led to the fact that so far there is no universal approach for all the cases. Integra™ artificial skin is an excellent choice for the treatment of congenital melanocytic nevi, especially for paediatric patients.

A new approach for treatment of congenital melanocytic nevi with hypertrichosis: the Depilendolaser technique

Congenital melanocytic nevi (CMN) are proliferations of cutaneous melanocytes which are present at birth or may develop during the first postnatal weeks. In 50% of the cases, hypertrichosis is also present. Lasers as CO2, normal mode ruby, Q-switched ruby, Q-switched alexandrite (755 nm) and Qswitched neodymium:yttrium-aluminium-garnet (Nd:YAG) 532 and 1064 nm can be used for the treatment of some CMN. There is a new technique of treatment for the congenital melanocytic nevi with hypertrichosis with a good improvement on reducing pigmentation and hypertrichosis. The authors describe their experience with a new laser technique for the depigmentation and the epilation of CMN with hypertrichosis: the Depilendolaser (Depigmentation Epilation, Endolaser) technique. In this procedure, CMN were treated with a subcutaneous approach by a LBO diode-pumped laser Quanta D - Quanta System S.p.A., Italy (wavelength = 532 nm) and with a cutaneous approach by Versapulse Select Lumenis® (wavelength = 532 nm). Histology was performed on CMN tissue samples. Over a 2-year period, 25 subjects were treated using Quanta D ® (wavelength = 532 nm) power 8 W, frequency 4.9 Hz and 0.48 J/60 ms pulse, through a 300-μm fibre optic for treatment from underneath the derma to the surface, and using the frequency-doubled Q-switched Nd:YAG laser (wavelength = 532 nm) Versapulse Select (Lumenis Ltd.,Yokneam, Israel) QS 532 nm, round spot size of 3 mm in diameter, fluence 2 J/cm2, energy 0.20 J/10 ms pulse and frequency 10 Hz, for the treatment from the surface to the depths. The Depilendolaser technique resulted to produce greater hair loss in the treated area with significant depigmentation and a relevant aesthetic improvement. Histopathological examination of the lesions after treatment, in comparison with non-treated areas of the same gigantic nevi, shows loss of pigmented melanocytic nests and hair follicles—often numerous and normotrophic in these congenital nevi—disappear after treatment with the new laser technique. The authors describe a new laser technique for depigmentation and epilation and their experience in the treatment of CMN with hypertrichosis. Data collected in this study showed first of all an extreme safety and tolerability of the procedure in children and young patients, with no adverse effects such as skin atrophy, pathological scarring and aesthetic improvement. Level of evidence: Level I, therapeutic; risk/prognostic study.

The outcome of using different surgical modalities and laser therapy in the treatment of small‐ and medium‐sized congenital melanocytic nevi: a systematic review

The purpose of this study is to review the published articles regarding different surgical modalities including laser therapy in the treatment of congenital melanocytic nevi (CMN). A systematic review was done using several databases including PubMed, Ovid Medline, Google Scholar, and Medline to search for articles related to surgical excisions and different treatment modalities of CMN. Fourteen studies were included according to the inclusion and exclusion criteria. The results have shown that the Q-switched ruby laser therapy was the most commonly used laser therapy to treat CMN. Overall, using laser therapy had positive outcomes in CMN treatment. However, limited knowledge was available regarding patient satisfaction with the outcomes of laser therapy. We concluded that the most acceptable surgical choice was using excision with tissue expanders. Laser-intense pulsed light (IPL) alone and in combination with Erbium:yttrium-aluminum-garnet (Er:YAG) has a risk of recurrence. Combination of types of the laser is more effective than a single one.

Treatment of Congenital Melanocytic Nevi in the Eyelid and Periorbital Region With Ablative Lasers.

Congenital melanocytic nevi (CMN) that occur on the eyelid and periorbital region cause cosmetic disfiguring. Laser treatment has aroused interest as an alternative treatment method, and resurfacing lasers have shown promising results. This study aimed to evaluate the efficacy and safety of carbon dioxide laser and erbium:yttrium aluminum garnet laser to treat CMN of the eyelid and periorbital region. Twenty patients with CMN were included in this study and were treated with either the CO2 or erbium:yttrium aluminum garnet laser. Clinical efficacy outcomes were evaluated by visual assessment and L*a*b* color space evaluation at least 6 months after treatment. The average (SD) visual evaluation improvement, assessed on a 5-point scale, was 2.8 (1.27). The mean (SD) values of the relative L* improvement rate and blanching rate of the CMN lesion were 32.0% (47.9%) and 34.1% (36.2%), respectively. Spearman rank correlation coefficient between the objective and subjective evaluations was significant (P < 0.001). Three cases developed partial hypopigmentation. No patient developed hypertrophic scars. The outcomes after laser treatment were variable, although half of the patients achieved greater than 50% clearance. It provides an alternative to surgical excision for the removal of CMN in the difficult regions. Surgery excision is inevitable for some patients.

Multidisciplinary long-term care and modern surgical treatment of congenital melanocytic nevi - recommendations by the CMN surgery network.

In recent years, our knowledge of congenital melanocytic nevi (CMN) has greatly expanded. This has led to a paradigm shift. The present article represents a commentary by an interdisciplinary group of physicians from German-speaking countries with extensive experience in long-term care and surgical treatment of children and adults with CMN (CMN surgery network, "Netzwerk Nävuschirurgie", NNC). The authors address aspects such as the indication for treatment as well as treatment planning and implementation under these new premises. Adequate counseling of parents on conservative and/or surgical management requires an interdisciplinary exchange among physicians and individualized planning of the intervention, which frequently involves a multi-stage procedure. Today, the long-term aesthetic outcome is at the center of any therapeutic endeavor, whereas melanoma prevention plays only a minor role. The premise of "removal at any cost" no longer holds. Potential treatment-related adverse effects (hospitalization, wound healing disorders, and others) must be carefully weighed against the prospects of a beneficial outcome. In this context, the use of dermabrasion in particular must be critically evaluated. At a meeting of the NNC in September 2018, its members agreed on a consensus-based position on dermabrasion, stating that the procedure frequently leads to impaired wound healing and cosmetically unfavorable or hypertrophic scarring. Moreover, dermabrasion is considered to be commonly associated with considerable repigmentation that usually occurs a number of years after the procedure. In addition, the NNC members saw no benefit in terms of melanoma prevention. In the future, physicians should therefore thoroughly caution about the potential risks and often limited cosmetic benefits of dermabrasion.

Laser treatment of congenital melanocytic nevi: a review of the literature.

Congenital melanocytic nevi (CMN) are nevi that are present from birth and occur in approximately 1% of newborns. CMN may be cosmetically disfiguring and are at risk for malignant transformation. For these two reasons, CMN are frequently treated. A variety of treatment modalities have been utilized with variable efficacy, including excision, dermabrasion, curettage, chemical peels, radiation therapy, cryotherapy, electrosurgery, and lasers. The current treatment of choice for CMN is surgical excision. However, some CMN occur in cosmetically sensitive areas, where a surgical scar is less acceptable, or in inoperable locations. For these reasons, there has been increasing interest in the potential for laser treatment of CMN. The lasers that have been studied to date for the treatment of CMN include pigment-specific lasers, including ruby (694nm), alexandrite (755nm), and Nd:yttrium aluminum garnet (YAG) (1064nm), as well as ablative laser treatment with CO2 laser (10,600nm) and Er:YAG (2940nm). To date, ruby lasers have been studied most extensively in the treatment of CMN. Ruby laser has been shown to improve the cosmetic appearance of some CMN and may be cautiously considered for lesions located in cosmetically sensitive areas that are less amenable to surgical excision. For very large CMN, ruby laser has been tried as an alternative to extensive surgical and grafting procedures. Dual treatment with Q-switched ruby laser and normal mode ruby laser may provide the best outcomes; however, multiple treatment sessions should be anticipated. The practicality and expense of multiple treatments should be discussed with the patient prior to initiating treatment. Importantly, because of the persistence of dermal nevus cells, lifelong follow-up is required for all laser-treated CMN, even those with excellent cosmetic effect.

Core concepts in congenital melanocytic nevi and infantile hemangiomas

Congenital melanocytic nevi (CMN) and infantile hemangiomas are commonly encountered in newborns and may present diagnostic and therapeutic dilemmas for medical practitioners. Herein, we review and discuss these two important clinical entities and focus on core issues and recent advances. Melanoma risk for patients with CMN is greatest in infants with large CMN located on the trunk, CMN greater than 40 cm, and multiple satellite nevi. Recent histological and molecular findings have been described to assist in differentiating benign proliferative nodules arising in CMN from melanoma. Multiple CMN and associated neurological lesions have recently been shown to be due to a single postzygotic mutation in NRAS [neuroblastoma RAS viral (v-ras) oncogene homolog]. Over the last several years, numerous advancements have occurred in redefining the clinical course of infantile hemangiomas, describing clinical syndromes associated with infantile hemangiomas and treating complicated infantile hemangiomas. The nonselective β-blocker propranolol has become first-line therapy for the treatment of complicated infantile hemangiomas. Topical timolol shows promise for the treatment of certain types of infantile hemangiomas. Although most CMN and infantile hemangiomas do not require active intervention, understanding which lesions may impact the overall health of the infant assists in early intervention. This article touches on core concepts in the clinical evaluation and treatment of CMN and infantile hemangioma.

Effective treatment of congenital melanocytic nevus and nevus sebaceous using the pinhole method with the erbium-doped yttrium aluminium garnet laser.

Dear Editor: Congenital melanocytic nevus (CMN) is a melanocytic nevus that is either present at birth or appears during the latter stages of infancy1. Nevus sebaceous has been described as the hamartomatous locus of an embryologically defective pilosebaceous unit2. Here, we describe how we used the pinhole technique with an erbium-doped yttrium aluminium garnet (erbium : YAG) laser to treat nevi lesions in different patients. A 25-year-old male was diagnosed with CMN on his nose at birth (Fig. 1A). Emla cream (AstraZeneca AB, Sodertalje, Sweden) was applied to the treatment area prior to starting the procedure. The erbium : YAG laser (Action Er : YAG; Lutronic Corporation, Goyang, Korea) was used in continuous-wave mode, with 1-mm spot size and output power of 0.2 mJ/cm2. Multiple small holes measuring 1 mm in diameter were made on the periphery of the CMN lesion. A hydrocolloid dressing (DuoDERM Extra Thin CGF dressing; ConvaTec, ER Squibb & Sons, Princeton, NJ, USA) was applied to the lesions for ≥2 weeks after treatment. After performing 5 laser sessions at 4-week intervals, the cutaneous lesions resolved. There was no evidence of recurrence at the 1-year follow-up examination (Fig. 1B). Fig. 1 Congenital melanocytic nevus (CMN) in a 25-year-old man. (A) Before treatment: a solitary, 1-cm brown patch is visible on the right alar area of the nose. (B) One year after the final treatment session, the skin lesions resolved with minimal scarring. ... A 5-month-old infant was referred to our outpatient unit for CMN on the forearm (Fig. 1C). We performed the pinhole method of treatment using the erbium : YAG laser (Lutronic) in continuous-wave mode, with 1-mm spot size and output power of 0.2 mJ/cm2 (Fig. 1D). After receiving 6 treatment sessions at 2-month intervals, slight superficial pigmentation persisted (Fig. 1E). A 40-year-old woman presented with nevus sebaceous lesions on the right side of her forehead (Fig. 2A). We performed the pinhole method of treatment using the erbium : YAG laser (Lutronic) in continuous-wave mode, with 1-mm spot size and output power of 0.2 mJ/cm2. After receiving 5 treatment sessions at 4-week intervals, the patient showed marked improvement with only mild hypopigmentation (Fig. 2B). No recurrence was noted at the 6-month follow-up examination (Fig. 2C). Fig. 2 Nevus sebaceous lesions in a 40-year-old woman. (A) Before treatment, two 2.5-cm, well-demarcated, yellow, verrucous plaques were visible on the right side of the forehead. (B) Deep line- and doughnut-shaped holes were created to remove the nevus sebaceus ... Herein, we described how nevi lesions were effectively treated using the pinhole method. This simple method involves making multiple small holes at 2~5-mm intervals using a CO2 laser that penetrates the epidermis and deeper dermis3. The holes produced using the pinhole method are surrounded by untreated areas that promote rapid epidermal repair, thereby reducing the downtime and likelihood of side effects4. The other advantages of performing the pinhole method with ablative lasers are that this laser is easy to use and inexpensive, as ablative lasers are usually available in most dermatology clinics. To the best of our knowledge, this is the first report on the application of the pinhole method for the treatment of CMN and nevus sebaceous, so it is difficult to compare the advantages and disadvantages of the pinhole method with those of conventional treatment methods. Therefore, it is necessary to conduct further studies with a large sample to confirm the effectiveness and safety of the pinhole method. In conclusion, we suggest using the pinhole method with erbium : YAG laser as an alternative therapy for treating nevi lesions.

Successful treatment of congenital melanocytic nevus on tragus with CO2 laser

Background: Congenital melanocytic nevus (CMN) has an increasing risk of malignancy and may cause cosmetic and psychological problems. Surgery has been the main therapy for most cases. However, it is often not suitable for all lesions. Treatment of these lesions can be challenging to plastic surgeons. CO2 laser, with the special function, is another effective treatment for some CMN. Methods: Both lesions were treated with a short-pulsed CO2 laser in conjunction with a local anesthetic; the superfluous tissue was pruned and ablated to get a crude tragus and then carefully shaped to form an aesthetically tragus. Results: Showed good cosmetic results without pigment recurrence and scar formation 1 year after operation in both patients, the exception being a small area of cartilage that was covered with epithelial tissues on the surface in patient 1. Conclusions: CO2 laser treatment is a useful modality in treating some CMN that are located on sites deemed inoperable. It can help to shape the lesions into their original form with the advantage of hemostasis and tissue manipulation proving to be effective, thus avoiding suturing and skin grafting. Taking the thermal damage into account can help to minimize the side effects and attain a desirable cosmetic outcome.

Kongenitale Nävi im Kindesalter

Nevi represent congenital hamartomatous malformations of various components of the skin. The most common forms are congenital melanocytic nevi (CMN) and nevi of epithelial origin (epidermal and organoid nevi). Large CMN in particular can lead to severe complications and the management of those affected represents a challenge from birth. In contrast to previous assumptions, the risk of malignancy from CMN is considered to be relatively low however, this may be relevantly increased in certain situations. Possible extracutaneous symptoms in cases of central nervous system (CNS) involvement should not be underestimated and early imaging investigations are part of the routine diagnostic procedure. Surgical measures are still very important in the treatment of CMN but the indications must be weighed up for each individual case. Patients often experience marked stigmatization due to disfigurement by their birthmark and this needs to be taken into consideration for their treatment. The most common epithelial nevi are sebaceous nevi. In 2-13% of cases additional tumors occur within this nevus and early surgical excision is indicated in most cases, not least for aesthetic reasons. If generalized spreading of epidermal nevi occurs, additional investigations are necessary to exclude associated ophthalmological, cardiac or neurological malformations.

Congenital melanocytic nevi: Where are we now?

Treatment of congenital melanocytic nevi (CMN) is generally undertaken for 2 reasons: (1) to reduce the chances of cutaneous malignant melanoma and (2) for cosmetic reasons. Over the past century, a large number of treatments for CMN have been described in the literature. These include excision, dermabrasion, curettage, chemical peels, radiation therapy, cryotherapy, electrosurgery, and lasers. Only low-level evidence supporting these approaches is available, and large randomized controlled trials have not been published. This article explores therapeutic controversies and makes recommendations based on the best available evidence.

Orbit high energy ultrapulse CO2 laser in treatment of congenital melanocytic nevus

Objective To valuate the effect of high energy ultrapulse CO2 laser on congenital melanocytic nevi of the orbit. Methods 46 patient with congenital melanocytic nevi of eyelid, 58 le-sions were vaporized with high energy ultrapulse CO2 laser. The area of the largest one was 3.0 cm×6.0 cm, and the smallest one was 0.3 cm×0.3 cm, with average of 1.3 cm×2.0 cm. The depth of the vaporizing reached the layer of lowest skin, even the orbicularis, aponeurosis and conjunctiva of tarsus, till no melanin on the wound in view, tried the best to reserve the normal follicle of eyelash. There was no eschar and bleeding on the wound during the procedure. Followed up lasted for 1 - 56 months, with average 12.9 months. Results 44 of 46 patients were satisfactory to the effect of the laser. The most of scars resulted from the vaporizing with the laser became evenness and smooth (50/58). The edge of eyelid looked normal after the laser. The excellent result was observed in 84.5 % (49/58) lesions, good in 10.3 % (6/58), and improved in 5.2 % (3/58). The overall effect was 94.8 % (55/58). And eyelashes were getting growth. Conclusion The treatment of con-genital melanocytic nevus of eyelid with high energy ultrapulse CO2 is a good method. But to be careful in selecting the lesions that may not he too large. Key words: Laser; Congenital melanocytic nevus; Eyelid

Congenital Melanocytic Nevi: Treatment Modalities and Management Options

Congenital melanocytic nevi can be cosmetically disfiguring, give rise to melanoma, and suggest the presence of neurocutaneous melanocytosis. Management decisions must be tailored for each patient and each nevus, taking into consideration the risk for developing malignancy, risk for developing symptomatic neurocutaneous melanocytosis, cosmetic implications of having the nevus, cosmetic implications of any resultant surgical scars from their removal, adverse effects that the nevus may have on psycho-social development, and the adverse effects and long-term sequelae of any surgical intervention. The advantages and disadvantages of different modalities used in the treatment of congenital melanocytic nevi are discussed. Organizational flow diagrams are presented to help clinicians in managing patients with different sized congenital melanocytic nevi.

Treatment of Congenital Melanocytic Nevi Using the Combined (Normal-Mode Plus Q-Switched) Ruby Laser in Asians: Clinical Response in Relation to Histological Type

Treatment of Congenital Melanocytic Nevi Using the Combined (Normal-Mode Plus Q-Switched) Ruby Laser in Asians: Clinical Response in Relation to Histological Type

Aesthetic surgery – pertinent papers 2002–2003: A personal view

Aesthetic surgery – pertinent papers 2002–2003: A personal view