The use of 2940‐nm ER:YAG laser for the treatment of lentigo maligna

Summary Objectives Lentigo maligna is a common in situ malignancy in elderly patients, with a low risk of progression to an invasive tumor. Surgical treatment may be complicated or refused. Non‐surgical treatment options (such as lasers) may therefore be needed. Patients and Methods We report on 17...

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Published in:Journal der Deutschen Dermatologischen Gesellschaft 2019-04, Vol.17 (4), p.425-431
Main Authors: Fikrle, Tomáš, Divišová, Barbora, Šuchmannová, Jitka, Pizinger, Karel
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aluminum
Anesthesia
Dermoscopy - methods
Female
Geriatrics
Humans
Hutchinson's Melanotic Freckle - diagnostic imaging
Hutchinson's Melanotic Freckle - pathology
Hutchinson's Melanotic Freckle - radiotherapy
Laser Therapy - methods
Lasers
Lasers, Solid-State - therapeutic use
Male
Malignancy
Neoplasm Recurrence, Local
Patient Satisfaction
Patients
Pigmentation
Prospective Studies
Skin
Skin Neoplasms - diagnostic imaging
Skin Neoplasms - pathology
Skin Neoplasms - radiotherapy
Surgery
Treatment Outcome
Tumors
Yttrium
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Summary:Summary Objectives Lentigo maligna is a common in situ malignancy in elderly patients, with a low risk of progression to an invasive tumor. Surgical treatment may be complicated or refused. Non‐surgical treatment options (such as lasers) may therefore be needed. Patients and Methods We report on 17 patients treated with a 2940‐nm Er:YAG (erbium‐doped yttrium aluminum) laser for histopathologically confirmed lentigo maligna. The lesions were ablated with a 5 mm margin of adjacent skin under local anesthesia with a 3.5 mm overlapping spot, energy density of 6.5 J/cm2 and a repetition rate of 5 Hz. If clinically visible pigmentation was seen in the ablated area during the following three months, the lesion was re‐treated. All patients were followed up for residual or recurrent tumors. Results We achieved clinical clearance in all 17 patients. There were three recurrences during the follow‐up period (9, 30 and 36 months after laser therapy). All patients were satisfied with the treatment course and cosmetic outcome. The mean follow‐up duration was 28 months. Conclusions Laser ablation is an interesting alternative method for treatment of lentigo maligna. It can be used for selected cases where surgery is contraindicated, complicated or declined by the patient.
ISSN:1610-0379
1610-0387
DOI:10.1111/ddg.13814