Q-SWITCHED RUBY-LASER TREATMENT OF OCULODERMAL MELANOSIS (NEVUS OF OTA)

The Q-switched ruby laser at 694 nm, a wavelength well absorbed by mel anin relative to other optically absorbing structures in skin, causes highly selective destruction of pigment-laden cells. In addition, the 20- to 40-ns pulse duration produced by this laser approximates the th ermal relaxation time for the melanosomes, thereby confining the energ y to the target. The Q-switched ruby laser was used to treat 47 patien ts (11 males and 36 females) with nevus of Ota during the period Decem ber 1991 to 1994. The involved facial area ranged from 3 x 3 cm(2) to 20 x 20 cm(2). The energy fluence used varied from 8 to 10 J/cm(2), an d the number of treatments ranged from 1 to 8 (mean 3.4). The results were graded on the basis of cleaning and fading as follows: poor (0 to 25 percent), fair (26 to 50 percent), good (51 to 75 percent), and ex cellent (76 to 100 percent). The mean follow-up period was 15 months. Poor and/or fair results were found in 8 patients who received one tre atment and 7 patients who had two treatments. Good results were seen i n 1 patient who had two treatments, 7 patients who received three trea tments, and 3 patients who had four treatments. Twenty-one patients ha d excellent results after three or more treatments of the whole lesion . In conclusion, this laser system produces clinically significant fad ing of nevus of Ota in patients without complications such as hypertro phic scarring or permanent changes in the normal skin pigmentation.