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Title: Modified laser toning with IPL , QS-ND:Yag combination for melanosis of face and neck

Nand Lal Sharma

National Skin Clinic, India

Biography

Dr NL Sharma MD was Professor and Head of Dermatology Deptt in IG Medical College Shimla India and RPG Medical College Tanda Kangra India till 2011. He has got about 150 research papers and about three fourth of them cited in PUBMED. His main work is in clinical Dermatology with main emphasis on Deep mycoses and Cutaneous leishmaniasis. He has delivered several talks in National Conferences of India and awarded Shroff Oration, and Best Teacher Award in National Conferences (Dermacons) of India

Presently Dr Sharma is Director-Consultant in National Skin Clinic at Palampur Himachal Pradesh India, where he is practicing Clinical Dermatology as well as Laser cosmetology.

Abstract

Introduction:

Dermal Pigmentation of face and neck is a common refractory condition of varied etiology with minimal effective remedial modalities available. Inspired by the study of combined IPL plus 1064nm QS- ND: Yag treatment for melasma by Cunha et al from Brazil, where they showed moderately good results in decreasing melasma pigmentation, we conducted a study on three patients of refractory melanosis of face and neck with the a similar combination of laser lights.

Material and Methods:

Out of the three patients, two were of lichen planus pigmentosus (LPP) of primarily neck and face of recent onset while third one was of toxic melanosis of face and neck of long duration. There were two females and one male with age ranging from 32- 58 yrs. They were given a first session of IPL with 1) 560nm filter with a pulse of 50 ms and fluence of 22 J/cm, 2) 590nm filter with 50 ms pulse and fluence of 12 J/sq cm and 3) 530nm filter with 50ms pulse and fluence of 24-30 J/sq cm (different areas of face and neck) followed by four sessions of  1064 nm QS- ND:Yag in a dose of 500mJ (LPP cases) and 300mJ  Toxic melanosis at an interval of two weeks each. Photographs were taken at baseline, at the end of treatment and two months after end of treatment.

Results :

Two of the patients with LPP pigmentation showed moderately good results by decrease of pigmentation of almost 70- 80%, while the third one did not show much difference.

Conclusion:

Combined treatment with IPL plus QS-ND: Yag laser provides an option for the otherwise refractory melanosis of LPP while the toxic melanosis remains a poor responder. Larger studies are required to further assess this modified laser modality of IPL combined with QS-ND:Yag.

Limitation of study: Exact similar parameters of dosing were not used because of tolerance by the individual patient.