Successful treatment of argyria using a low‐fluence Q‐switched 1064‐nm Nd:YAG laser

Han, Tae Young; Chang, Hee Sun; Lee, Hyun Kyung; Son, Sook‐Ja

doi:10.1111/j.1365-4632.2010.04796.x

Cited by 22 publications

(33 citation statements)

References 9 publications

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“…As such, argyria has been considered by some sources to be a permanent dyspigmentation, with no effective treatments. [7, 35] Recent data[21-23], including our own findings, suggest that the QS 1064 nm Nd:YAG laser can be clinically effective for removing dyspigmentation.…”

Section: Discussionmentioning

confidence: 84%

“…[21, 22] However, long-term clinical follow-up was not provided. Our results indicate not only long-term clinical improvement in the treatment of argyria with the QS laser, but also shows that the character of the cutaneous deposits was permanently altered, corresponding with the change in clinical phenotype..…”

Section: Discussionmentioning

confidence: 99%

“…[21, 22] While both these reports exhibited successful clinical pigment clearing, follow-up periods were short (4 weeks and 3 months) and treatment sites were focal (forehead and face). Very recently, another case study has also been reported [23].…”

Section: Introductionmentioning

confidence: 99%

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Quantitative near infrared spectroscopic analysis of Q‐Switched Nd:YAG treatment of generalized argyria

et al. 2013

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Background and Objective Generalized argyria is a blue-gray hyperpigmentation of the skin resulting from ingestion or application of silver compounds, such as silver colloid. Case reports have noted improvement after Q-Switched Neodymium--Yttrium Aluminum Garnet laser (1064nm QS Nd:YAG) laser treatment to small surface areas. No reports have objectively monitored laser treatment of generalized argyria over large areas of skin, nor have long-term outcomes been evaluated. Study Design/Materials and Methods An incremental treatment plan was developed for a subject suffering from argyria. A quantitative near infrared spectroscopic measurement technique was employed to non-invasively analyze tissue-pigment characteristics pre- and post-laser treatment. Post-treatment measurements were collected at weeks 1, 2, 3, and 4, and again at 1 year. Results Immediate apparent removal of pigment was observed with 1 Q-switched 1064 nm Nd:YAG laser treatment (3-6 mm spot; 0.8-2 J/cm2) per area. Entire face, neck, upper chest and arms were treated over multiple sessions. Treatments were very painful and general anesthesia was utilized in order to treat large areas. Near-infrared spectroscopy was used to characterize and quantify the concentration of silver particles in the dermis based on the absorption features of the silver particles as well as the optical scattering effects they impart. We were able to estimate that there was, on average, 0.042 mg/mL concentration of silver prior to treatment and that these levels went below the minimum detectable limit of the instrument post-treatment. There was no recurrence of discoloration over the 1-year study period. Conclusion QS 1064 nm laser treatment of argyria is a viable method to restore normal skin pigmentation with no evidence of recurrence over study period. Quantitative spectroscopic measurements, 1) confirmed dyspigmentation was due to silver, 2) validated our clinical assessment of no recurrence up to one year post-treatment and 3) indicated no collateral tissue damage with treatments.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Quantitative near infrared spectroscopic analysis of Q‐Switched Nd:YAG treatment of generalized argyria

et al. 2013

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“…[46] In another case report acitretin improved clinical lesions of blastomycosis like pyoderma resistant to all conventional therapies within 3 months of starting treatment and there was nonrecurrence until 9 months of stopping therapy. [47] Acitretin has been reported to cause improvement with almost complete clearing in cutaneous lesions of a 64-year-old case of elephantiaisis nostras verrucosa (nonfilarial in origin) with coexisting erythrodermic psoriasis.…”

Section: Infectionsmentioning

confidence: 98%

Acitretin in dermatology

Sarkar¹,

Chugh²,

Garg³

2013

Indian J Dermatol Venereol Leprol

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Acitretin, a synthetic retinoid has gradually replaced etretinate in today's dermatologic practice because of its more favorable pharmacokinetics. Acitretin over the past 20 years has proven useful in a number of difficult-to-treat hyperkeratotic and inflammatory dermatoses and nonmelanoma skin cancers. It is effective both as monotherapy and in combination with other drugs for hyperkeratotic disorders. It is considered to be an established second line treatment for psoriasis and exerts its effect mainly due to its antikeratinizing, antiinflammatory, and antiproliferative effect. Its antineoplastic properties make it a useful agent for cancer prophylaxis. Evidence-based efficacy, side-effect profile, and approach to the use of acitretin would be discussed in this review. In addition to its approved uses, the various off label uses will also be highlighted in this section. Since its use is limited by its teratogenic potential and other adverse effects, including mucocutaneous effects and hepatotoxicity, this review would summarize the contraindications and precautions to be exercised before prescribing acitretin.

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“…Recently, Q-switched 1064-nm neodymium-doped yttrium aluminium garnet laser has been reported to be useful for resolving the skin discoloration in argyria. [42,47,50,54] Indian perspective All the four cases of argyria, described in this article are due to intake of silver coated betel nut/cardamoms [ Table 1]. An extensive literature search conducted with the purpose to identify the reports of argyria pertaining to related forms of exposure yielded five citations.…”

Section: Discussion Discussionmentioning

confidence: 98%

Estimation of serum level of interleukin-17 and interleukin-4 in leprosy, towards more understanding of leprosy immunopathogenesis

Abdallah¹,

Emam²,

Attia³

et al. 2013

Indian J Dermatol Venereol Leprol

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Successful treatment of argyria using a low‐fluence Q‐switched 1064‐nm Nd:YAG laser

Abstract: A low-fluence Q-switched 1064-nm Nd:YAG laser provided safe and effective treatment for the skin discoloration associated with argyria.

Cited by 22 publications

References 9 publications

Quantitative near infrared spectroscopic analysis of Q‐Switched Nd:YAG treatment of generalized argyria

Quantitative near infrared spectroscopic analysis of Q‐Switched Nd:YAG treatment of generalized argyria

Acitretin in dermatology

Estimation of serum level of interleukin-17 and interleukin-4 in leprosy, towards more understanding of leprosy immunopathogenesis

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