|
KMID : 0363220160540080676
|
|
Korean Journal of Dermatology
2016 Volume.54 No. 8 p.676 ~ p.678
|
|
|
Acquired Dermal Melanocytosis of the Nose Successfully Treated with Neodymium-doped Yttrium Aluminum Garnet 1064 nm Laser
|
|
Han Ju-Hee
Lee Jun-Young
Park Young-Min
Lee Ji-Hyun
|
|
|
Abstract
|
|
|
|
A 28-year-old woman presented with asymptomatic, diffuse, irregularly shaped, grayish patches on the nasal alae, septum, and nostrils (Fig. 1A). The patches had been growing for 5 years. No history of contact, prior inflammation, trauma, or significant sun exposure was found. Histological examination showed melanocytes dispersed in the upper and mid-dermis (Fig. 2A, B). Fontana-Masson and Melan-A staining showed increased dermal melanin pigment and dermal melanocytes, respectively (Fig. 2C, D). The lesion subsided significantly after six sessions of treatment with a 1,064 nm neodymiumdoped yttrium aluminum garnet (Nd:YAG) laser (each four sessions of 1,064 nm, 2 Hz, 2.0 J/cm2, and 5 Hz, 1.4 J/cm2; and each two sessions of 1,064 nm, 5 Hz, 2.0 J/cm2, and 10 Hz, 1.4 J/cm2), without complications (Fig. 1B). Dermal melanocytosis is defined as a broad group of congenital and acquired melanocytic lesions characterized by intradermal dendritic, variably pigmented, spindle-shaped melanocytes, with or without dermal melanophages. Clinically, this group may show several morphological forms, such as Mongolian spot, blue nevus, nevus of Ota, nevus of Ito, and Acquired, bilateral nevus of Ota-like macules (ABNOM). Acquired dermal melanocytosis (ADM) usually presents symmetrically, similar to ABNOM. In in cases where a definite diagnosis cannot be made, we can use the term “dermal melanocytosis”. Rarely, there are reports of localized and asymmetric ADM on the face, and other areas of the body1-3. Localized ADM on the nose, especially on the nasal alae, septum, and nostrils, as in our case, is a rare condition, but it is often found in Asians2. However, to the best of our knowledge, localized ADM of the nose has not been reported in the Korean literature. According to previous literature, cryotherapy and dermabrasion are known to be successful as treatment options4,5. However, these modalities are invasive and can lead to many complications. Therefore, Q-switched Nd:YAG lasers, known as “laser toning”, recently became a widely used treatment modality for dermal melanocytosis, especially ABNOM and nevus of Ota. The 1,064 nm Nd:YAG laser shows highly selective destruction of melanin within the aberrant dermal melanocytes, and its longer wavelength results in relatively deep penetration into the skin, bypassing the epidermis, to target the aberrant dermal melanocytes. At this wavelength, melanin preferentially absorbs laser energy more than other chromophores, and the surrounding normal skin sustains minimal injury5. Thus, reporting this rare clinical manifestation of ADM and a successful treatment outcome may offer several possible therapeutic options, and generate awareness about such a presentation.
|
|
|
KEYWORD
|
|
|
Dermal melanocytosis, Neodymium-doped yttrium aluminum garnet laser
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|
|