Laser therapy and light sources for labial lentigines in patients with Peutz‐Jeghers  syndrome

Abstract

Labial lentigines associated with Peutz‐Jeghers syndrome are challenging and represent a cosmetic problem. Laser and intense‐pulsed light sources (IPLS) can be used to treat these macules. However, there are few guidelines regarding the different types of protocols found in the literature. Thus, the purpose of this study was to review the pertinent literature on lasers and IPLS as therapy for labial lentigines in patients with Peutz‐Jeghers syndrome. A detailed literature search was conducted in seven databases (Cochrane Library, Embase, Lilacs, PubMed, SciELO, Scopus and Web of Science) to November 2020. Data were extracted and analyzed from selected studies including study design, sample size, participants' skin color, age, and gender, parameters of the laser or IPLS used, interval and total sessions of laser application, results obtained, follow‐up time and side effects. Thirteen out of 124 published studies met our eligibility criteria, covering 81 patients. Ten types of lasers and IPLS were used, and most of the sample (n = 57) was treated with Q‐switch Alexandrite Laser (QSAL). The total number of sessions ranged from 1 to 12 and the interval between sessions ranged from 2 to 16 weeks. All studies have shown satisfactory results, with no further complications. The follow‐up ranged from 2 to 97 months. Laser therapy and IPLS are effective in the treatment of lentigines associated with PJS. Although QSAL was used in 70.3% of the sample, different types of lasers showed comparable satisfactory results.

Clinical Efficacy of 755 nm Laser Treatment of Lip Mucosal Pigmentation in Children with Peutz–Jeghers Syndrome

“…Previous treatments for PJS-related pigmentation, including surgical excision, electrocautery, liquid nitrogen freezing, and dermabrasion are invasive and often cause adverse efects, such as scarring, pigment changes, or infection [4]. With advances in laser therapy, efective treatment of PJS-related mucosal pigmentation was reported with a high safety profle [9] although evidence for children is lacking. We selected the Q-switched 755 nm laser for treatment of pediatric cases of PJS as it is noninvasive and provides a selective destruction of melanosomes in skin melanocytes with minimal damage to other cells and tissues and results in particle fragments removed by phagocytosis [10].…”

Síndrome de Peutz‐Jeghers: implicações clínicas, bioquímicas e epidemiologia

“…Anteriormente, as opções terapêuticas para tratar essas lesões eram a dermoabrasão, criocirurgia, excisão ou eletrocirurgia (9). No entanto, esses procedimentos resultavam em cicatrizes indesejáveis ou despigmentação.…”

“…Os lentigos labiais associados à síndrome de Peutz-Jeghers são desafiadores e representam um problema de origem estética (9). Laser e fontes de luz intensa pulsada (IPLS) podem ser usadas para tratar essas máculas melanocíticas da pele e das mucosas.…”