Ann Dermatol.  2015 Dec;27(6):751-755. 10.5021/ad.2015.27.6.751.

Hypopigmentation Induced by Frequent Low-Fluence, Large-Spot-Size QS Nd:YAG Laser Treatments

• Wong Y
• Lee SS
• Goh CL

• KMID: 2157454
• DOI: http://doi.org/10.5021/ad.2015.27.6.751

Abstract

The Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (QS 1064-nm Nd:YAG) laser is increasingly used for nonablative skin rejuvenation or "laser toning" for melasma. Multiple and frequent low-fluence, large-spot-size treatments are used to achieve laser toning, and these treatments are associated with the development of macular hypopigmentation as a complication. We present a case series of three patients who developed guttate hypomelanotic macules on the face after receiving laser toning treatment with QS 1064-nm Nd:YAG.

Keyword

Laser-induced hypopigmentation; Laser toning; QS 1064-nm Nd:YAG

MeSH Terms

Aluminum
Humans
Hypopigmentation*
Melanosis
Rejuvenation
Skin
Yttrium
Aluminum
Yttrium

Figure

• 

  Fig. 1 (A) Guttate hypopigmented macules on the face of the patient in case 1. (B) Case 1 patient after topical treatment for 2 years. (C) Areas showing preserved basal melanin pigmentation (left side of the epidermis) and decreased basal melanin pigmentation (right side of the epidermis) (Fontana-Masson stain, ×100). (D) In areas with preserved basal melanin pigmentation, the number of melanocytes was normal and the dendritic processes were prominent (Melanoma Triple Cocktail [human melanoma black 45+melan-A+tyrosinase], ×200). (E) Hypopigmented areas showed decrease in the number of melanocytes; their dendritic processes were also markedly reduced (Melanoma Triple Cocktail, ×200). (F) The number of melanocytes was preserved in the pigmented areas (microphthalmia transcription factor stain [MITF], ×200). (G) The number of melanocytes was decreased in the hypopigmented areas (MITF, ×200).

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  Fig. 2 Guttate hypopigmented macules on the face of the patient in case 2.

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  Fig. 3 Guttate hypopigmented macules on the face of the patient in case 3.

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