ALABASTER SKIN AFTER CARBON-DIOXIDE LASER RESURFACING WITH HISTOLOGICCORRELATION

BACKGROUND. Carbon dioxide laser resurfacing has gained popularity as a relatively safe and effective method of facial rejuvenation. Origina l reports describe mostly reversible side effects and a low incidence of scarring. Only very recently have reports of delayed hypopigmenteti on surfaced. This effect is not visible until several months after res urfacing, and most likely represents a permanent change. OBJECTIVE. To provide an additional clinical description of the complication of del ayed hypopigmentation along with the first published histologic correl ation. METHODS. Clinical records along with it preprocedure and 7-mont h postprocedure full-thickness skin biopsy were used for this report. RESULTS. This patient experienced a striking leukoderma 6 months after a fall facial carbon dioxide laser resurfacing procedure done for wid espread actinic keratoses. There was a zone of dermal fibrosis extendi ng approximately 0.4 mm on the postprocedure biopsy. Comparison of the preprocedure and postprocedure biopsies revealed no difference in the number of melanocytes by MART-1 immunohistochemical staining, but the re was a significant decrease in epidermal melanin as determined by Fo ntana-Mason staining. CONCLUSION. This patient experienced a profound expression of an increasingly recognized and reported complication of carbon dioxide laser resurfacing. Histologic correlation is similar to the results previously reported after phenol chemical peels, demonstr ating a normal number of melanocytes but a decrease in epidermal melan in. (C) 1998 by the American Society for Dermatologic Surgery, Inc.