Lentigo maligna--outcomes of treatment with Q-switched Nd:YAG and alexandrite lasers

Abstract

Background: Surgical excision is considered the criterion standard treatment for lentigo maligna (LM) but may sometimes be unsuitable for elderly people or in the treatment of large lesions.

Objective: To evaluate the role of Q-switched neodymium-doped yttrium aluminium garnet (QS:Nd:YAG) and alexandrite lasers in the treatment of LM.

Methods: QS:NdYAG and alexandrite lasers were used to treat histologically proven LM in 22 patients who were considered unsuitable for wide surgical excision or declined it. Patients were assessed at 6-month intervals for a maximum period of 5 years.

Results: Complete clinical response was achieved in 12 patients after one to four treatments and a follow-up of 2 to 5 years after last treatment. Excellent cosmesis was achieved in all patients. LM melanoma developed in two lesions, which were subsequently excised. Recurrence occurred in four patients.

Conclusion: Although QS:Nd:YAG and alexandrite laser treatment of LM produced long-term clearance in 12 of the 22 patients, the ease and speed of this treatment and excellent cosmetic outcome achieved make this a suitable alternative to surgical excision, especially in elderly people, in treatment of large lesions, or in patients who refuse surgical treatment.