Golden Parameter Therapy With a High-Fluence 1064-nm Q-Switched Nd:YAG Laser for Treating Partial Unilateral Lentiginosis

초록

Background: Partial unilateral lentiginosis (PUL) is a rare acquired hyperpigmented disorder presenting as clusters of small, brown macules on otherwise normal skin, limited to one side of the body, and typically emerging in childhood. Only a few cases of successful treatment have been documented, and a consistently effective therapy for achieving favorable cosmetic results has yet to be established. Objectives: This study was performed to investigate the effectiveness and safety of golden parameter therapy (GPT) employing a high-fluence 1064-nm Q-switched Nd:YAG laser (QSNL) for the treatment of PUL. Methods: The study involved 87 Korean patients with PUL, where 79 patients received weekly treatments using a 1064-nm QSNL under GPT for a total of 30-50 sessions. Treatment parameters included a 7 mm spot size, a 2.2 J/cm(2) fluence, and a 10 Hz pulse rate, with a single pass applied using a sliding-stacking technique over the PUL area. In contrast, a small alternative therapy group of eight patients underwent monthly treatment with a 532-nm picosecond laser for three sessions, using a 3 mm spot size, a 1 J/cm(2) fluence, and a 2 Hz pulse rate. Results: Following 30-50 GPT sessions using 1064-nm QSNL, 48 of the 79 patients achieved complete clearance (confluent brown patches type and mixed type: 60.8%), whereas 31 of 79 patients attained excellent clearance (grouped independent lentigines type: 39.2%). No significant side effects, such as purpura, crusting, postinflammatory hyperpigmentation, mottled hypopigmentation, or scarring, were observed. Additionally, no recurrences occurred in any patients over the 6-24-month follow-up period. In contrast, the small alternative therapy group of eight patients treated with the 532-nm picosecond laser showed poor treatment outcomes (100%). Conclusions: We propose that GPT with a high-fluence 1064-nm QSNL is a new, safe, and effective treatment for PUL, reducing side effects and preventing recurrences.

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