Soden, 2001  Title: Histologic features seen in changing
nevi after therapy with an 810 nm pulsed diode laser for hair
removal in patients with dysplastic nevi.
Authors: Soden CE, Smith K, Skelton H.
Journal: Int J Dermatol 2001 Aug;40(8):500-4
PMID: 11703520 ABSTRACT
Affiliated institution: 8373 Cherry
Lane, Laurel, Maryland, and the Departments of Dermatology and
Pathology, University of Alabama, Birmingham, Alabama, USA.
BACKGROUND: The majority of lasers used for hair
removal target melanin as the chromophore. In contrast with other
cutaneous applications of lasers, lasers used for hair removal
must generate a limited, controlled degree of thermal damage to
permanently remove hairs.
AIM: To remove excess back hair from two male patients,
one with a history of multiple nevi, and prior biopsies showing
features of dysplastic nevi, and the other with large nevi greater
than 6 mm in diameter and a family history of malignant melanoma.
METHODS: Both patients received monthly treatments
with an 810 nm, pulsed, high-power diode laser using a fluence
of 20 J/cm2 and 25-30 J/cm2, respectively, and a pulse duration
of 30 ms.
RESULTS: Both patients presented 1 month after their
last treatment with changing nevi within the treatment areas.
Neither patient had clinical inflammation or other alterations
suggestive of change in the nevi related to treatment. Thus, the
nevi were excised with no mention of the previous laser treatment.
The histologic features in all nevi were similar. There was subepidermal
blister formation with elongation and disruption of nevus cells.
There was homogenization of the collagen within the papillary
dermis in all lesions. Only small foci of nevus cells could be
identified in the dermis in some of the biopsy specimens. In these
biopsy specimens, the dermal stromal matrix homogenization extended
into the reticular dermis.
CONCLUSIONS: Laser targeting of nevus cells and
surrounding structures may produce clinically atypical nevi in
areas previously treated for hair removal. This should be kept
in mind, especially in patients with a history of dysplastic nevi
or with a personal or family history of malignant melanoma.
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