Clinically atypical nevi following diode laser therapy

Ashack, Kurt; Brewer, Jerry D.

doi:10.1111/ijd.13376

Cited by 3 publications

(10 citation statements)

References 6 publications

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“…Histologic changes included mild atypia, thermal damage, scar formation, and partial or complete regression. 4,[11][12][13][14][15] Although some of the clinical and dermoscopic alterations may be concerning for malignancy, there were no nevi with malignant transformation following LHR. Moreover, none of the observational studies reported changes concerning for malignancy that warranted a skin biopsy.…”

Section: Resultsmentioning

confidence: 94%

“…Histologic changes included mild atypia, thermal damage, scar formation, and partial or complete regression 4,11–15 . Although some of the clinical and dermoscopic alterations may be concerning for malignancy, there were no nevi with malignant transformation following LHR.…”

Section: Resultsmentioning

confidence: 94%

“…In comparison, 9 of 11 patient cases resulted in biopsy of at least one lesion of concern, and showed a variety of findings including subepidermal blister, increased melanophages, mild atypia, architectural changes, regression, and scar formation, however, notably no severe atypia or changes concerning for malignancy were noted. 4,[10][11][12][13][14][15]…”

Section: Resultsmentioning

confidence: 99%

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Changes in melanocytic nevi treated with laser hair removal: A systematic review

2023

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BackgroundIncidental treatment of melanocytic nevi during laser hair removal (LHR) has been noted to cause clinical and dermoscopic changes that may appear similar to findings seen in atypical or neoplastic melanocytic lesions. The rate and characteristics of these changes has not been well‐studied.ObjectivesThe objective of this review article is to assess the literature for reported changes in melanocytic nevi following LHR to guide clinical practice.MethodsPubMed was searched December 5, 2022 for articles evaluating changes in melanocytic nevi after LHR treatment using the following search terms: “nevi laser hair removal,” “nevi diode,” “nevi long pulse alexandrite,” “nevi long pulse neodymium doped yttrium aluminum garnet,” and “melanoma laser hair removal.” All English language patient‐based reports discussing incidental treatment of melanocytic nevi while undergoing LHR with a laser were eligible for inclusion, while reports of changes following hair removal with non‐laser devices such as intense pulsed light were excluded. Studies evaluating non‐melanocytic nevi such as Becker's nevus or nevus of Ota were excluded as were those evaluating the intentional ablation or removal of melanocytic lesions.ResultsTen relevant studies were included, consisting of seven case reports or series and three observational trials, two of which were prospective and one retrospective. Among the seven case reports or series there were a total of 11 patients, six of which had multiple affected nevi. Clinical and dermoscopic changes to nevi following LHR appear to be common in clinical practice, though not well studied. Clinical and dermoscopic changes have been noted to present as early as 15 days after treatment and persist to the maximum time of follow up at 3 years. Commonly reported changes include regression, decreased size, laser induced asymmetry, bleaching, darkening, and altered pattern on dermoscopy. Histologic changes include mild atypia, thermal damage, scar formation, and regression. Although some of the clinical and dermoscopic alterations may be concerning for malignancy, to our knowledge, there are no documented cases of malignant transformation of nevi following treatment with LHR.LimitationsThis study is limited by the low number of relevant reports and their generally small sample size, many of which is limited to single cases. Additionally, comparison of available data was limited by variable reporting of treatment regimens and outcomes.ConclusionsChanges to nevi treated during LHR are not uncommon. Modifications to nevi may occur and look similar to changes seen in dysplastic or neoplastic melanocytic lesions. Notably, despite the widespread use of LHR since the first device was Food and Drug Administration approved in 1995, a time span of nearly three decades, there have been no reported cases of melanoma or severe dysplastic changes within treated nevi. However, dermatologists should be aware that morphologic and dermoscopic alterations can occur after LHR to prevent unnecessary surgical procedures. Although melanoma has not been reported to occur in nevi treated with LHR nor with any other laser exposures, further long‐term data is needed to fully elucidate this concern. Optimally, nevi should be examined by a dermatologist before LHR to determine a baseline clinical and dermoscopic morphology. If there is concern for potential atypia, laser should be avoided over such nevi to avoid confusion at future follow up visits.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

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Changes in melanocytic nevi treated with laser hair removal: A systematic review

2023

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“…65 Hunziker et al also reported a case of a complete nevus regression in a 35-year-old woman who underwent hair removal treatment with IPL. 66 Although the sudden appearance of a clinically and histologically atypical nevus following laser hair removal has been reported in a 46-year-old man, 67 there is insufficient evidence to prove or disprove the hypothesis that laser therapy is to blame for the malignant transformation of benign nevi. 68…”

Section: Discussionmentioning

confidence: 99%

Adverse Events of Light-Assisted Hair Removal: An Updated Review

et al. 2023

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Background With light-assisted hair removal becoming widely used, reports of adverse effects are increasing. Objective To review all the reported optical incidents and cutaneous complications of laser or intense pulse light-assisted hair removal. Methods A PubMed database systematic search was performed to identify studies reporting such adverse events before July 2022 using the Mesh terms “adverse effects” AND “hair removal” AND (“laser” OR “intense pulse light”). Results Altogether, 358 references were identified. After excluding duplicates, unrelated articles, guidelines, and conference abstracts, then adding references from studies bibliography, 104 publications were included. Ocular incidents consisted of anterior uveitis, iritis and iris atrophy, pupillary distortion, posterior synechiae, anterior chamber pigment, and cataracts in the anterior subcapsular region. Cutaneous complications consisted of pain, burns, folliculitis, leukotrichia, paradoxical hypertrichosis, pigmentary changes, changes in nevi, pili bigemini, herpes infection, hyperhidrosis, bromhidrosis, Fox-Fordyce disease, and frostbite from the cooling system. They were mostly correlated to skin type and body area as well as to light device and set parameters. Intense pulse light devices were found to be less painful than alexandrite laser, yet more painful than diode laser; Nd:YAG laser had the highest pain score. Conclusion Optical incidents can be systematically avoided. Cutaneous complications are usually related to professional errors and patient characteristics. Better knowledge of laser physics and adequate training of laser operators are key recommendations to avoid undesirable side effects. Safety recommendations help prevent most of the reported complications.

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“…A nevus that was darkly pigmented and symmetrical, with a typical pigment network, but that was different from the patient’s signature nevus and darker and larger than other nevi, was noted on the back of an individual after two sessions of diode laser hair removal. The nevus was biopsied and subsequently excised [ 20 ]. Similarly, in another case, clinical changes were noted by a woman with a family history of melanoma, after diode laser epilation.…”

Section: Clinical Findings Of Pigmented Lesions After Laser or Ipl Ha...mentioning

confidence: 99%

Clinical and Dermoscopic Findings of Nevi after Photoepilation: A Review

Dessinioti,

Tsiakou,

Christodoulou

et al. 2023

Life

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Atypical clinical and dermoscopic findings, or changes in pigmented melanocytic lesions located on body areas treated with lasers or intense pulsed light (IPL) for hair removal (photoepilation), have been described in the literature. There are three prospective studies in a total of 79 individuals with 287 melanocytic nevi and several case reports reporting the dermoscopic findings and changes after photoepilation. Clinical changes have been reported in 20–100% of individuals, while dermoscopic changes have been observed in 48% to 93% of nevi. More frequent dermoscopic changes included bleaching, the development of pigmented globules, and irregular hyperpigmented areas and regression structures, including gray areas, gray dots/globules, and whitish structureless areas. The diagnostic approach for pigmented lesions with atypical dermoscopic findings and changes after photo-epilation included reflectance confocal microscopy, sequential digital dermoscopy follow-up, and/or excision and histopathology. Challenges pertaining to these diagnostic steps in the context of photoepilation include the detection of findings that may warrant a biopsy to exclude melanoma (ugly duckling, irregular hyperpigmented areas, blue-gray or white areas, and loss of pigment network), the potential persistence of changes at follow-up, and that a histopathologic diagnosis may not be possible due to the distortion of melanocytes or complete regression of the lesion. Furthermore, these diagnostic approaches can be time-consuming, require familiarization of the physician with dermoscopic features, may cause anxiety to the individual, and highlight that avoiding passes of the laser or IPL devices over pigmented lesions is key.

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Clinically atypical nevi following diode laser therapy

Cited by 3 publications

References 6 publications

Changes in melanocytic nevi treated with laser hair removal: A systematic review

Changes in melanocytic nevi treated with laser hair removal: A systematic review

Adverse Events of Light-Assisted Hair Removal: An Updated Review

Clinical and Dermoscopic Findings of Nevi after Photoepilation: A Review

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