Laser Treatment Pitfalls when Dealing with Pigmented Lesions and Tattoos
- Beware of skin colored tattooos (e.g around the mouth):
- Why ? There is high risk of pigment darkening upon removal (eg Q switched laser): thie pigment turns black (oxydation reaction)
- Solution: use COs laser ablation: superficial
- Beware of gold:
- Why ? if gold therapy was used for treatment of rhematoid arthririts, chrysiasis (deposit of gold it the skin) can be induced by laser-therapy (Q-switched laser)
- Solution: check the history with the patient before doing the treatments
- Beware of laser treatments in patients with latent vitiligo:
- Why ? Possible koebnerisation of vitiligo from the laser
- Solution: perform a full body examination to check if koebnerisation of skin diseases could happen
- Do not confuse lentigines with Hori’s nevus (bilateral acquired nevus of Ota):
- Hori’s nevus often requires multiple sessions of laser treatment
- lentigines usually respond after the first treatment session
- Laser treatment of junctional nevi:
- Why lesions can be incompletely removed and can look atypical
- Solution: do not treat nevi if they look atypical dermoscopically) and do not treat Caucasians (usually they don’t request it).
Contributors
Dr Christophe Hsu – dermatologist. Geneva, Switzerland
Source of Information: Lui H. Laser Pearls. Pearls from Clinical and Investigative Dermatology. 2014 (4) – 21st Regional Conference of Dermatology; Danang (Vietnam)
