Q-SWITCHED RUBY-LASER TREATMENT OF MUCOCUTANEOUS MELANOSIS ASSOCIATEDWITH PEUTZ-JEGHERS SYNDROME

Peutz-Jeghers syndrome is an eponym for circumscribed mucocutaneous me lanosis in association with gastrointestinal polyposis. Irregular pigm ented macules of varying size and color can be found on the perioral s kin, lip vermilion border, buccal mucosa, palate, and tongue. Previous treatments, such as surgical excision, cryosurgery, electrodesiccatio n, dermabrasion, and carbon dioxide or argon laser ablation commonly r esult in incomplete removal, scarring, or changes in normal pigmentati on. The Q-switched ruby laser used at 694 nm, a wavelength well absorb ed by melanin relative to other optically absorbing structures in skin , causes highly selective destruction of pigment-laden cells. In addit ion, the 20-nanosecond pulse duration produced by this laser approxima tes the thermal relaxation time for melanosomes, thereby confining the energy to the target. The Q-switched ruby laser produces clinically s ignificant fading of mucocutaneous melanosis in association with Peutz -Jeghers syndrome without complications often seen with other therapeu tic modalities.