Biomedical Engineering Reference
In-Depth Information
fi nal appearance 6 years later—15 years after the fi rst laser treatment—is shown in Figure 3.8F. The lesion was treated with
a topical anesthetic cream (EMLA®, AstraZeneca, Luton, UK) prior to each treatment.
(
A
)
(
B
)
(
C
)
(
D
)
(
E
)
(
F
)
Figure 3.8
(
A
) Nevus on the left upper lip of a 7-year-old girl. (
B
) Appearance after 4-monthly Q-switched ruby laser treatments. (
C
) 6 months later the
lesion began to recur. (
D
) After 3 separate Q-switched alexandrite laser treatments the lesion hass almost totally resolved. (
E
) Further treatment with the 5-ms
long pulsed alexandrite laser further improved the lesion and eliminated hairs within the lesion. (
F
) The fi nal appearance 10 years later.
Source
: Photos
courtesy of Mitchel P. Goldman, MD.
Case 9
Congenital Hairy Nevus
This 12-year-old girl was concerned over the cosmetic appearance of a congenital hairy nevus on her left cheek (Fig. 3.9A).
After a discussion with her parents regarding surgical excision versus laser treatment, a decision was made to treat the lesion
with laser therapy and a close clinical follow-up. Figure 3.9B shows the clinical appearance after 11 separate laser treatments
consisting of two Q-switched (QS) ruby laser treatments at 5 J/cm
2
, one 510-nm 300-ms pigment lesion laser at 3 J/cm
2
, one
QS 532-nm Nd:YAG treatment at 4 J/cm
2
, three QS alexandrite laser treatments at 7-8 J/cm
2
, three treatments with the long-
pulsed alexandrite laser at 5 ms and 20 J/cm
2
, and one treatment with the Lumenis Vasculite IPL (Lumenis Aesthetic, Yokneam,
Israel) with a 640-nm cut-off fi lter and a double pulse of 3 ms and 3 ms, 10-ms delay between pulses at an energy of 40 J/cm
2
.
The lesion has lightened and there is no more hair but the color has not resolved. Local anesthesia was performed with 1%
lidocaine with epinephrine infi ltrated into the lesion prior to each procedure to minimize pain.
(
A
)
(
B
)
Figure 3.9
(
A
) A congenital hairy nevus on the left cheek of a 12-year-old girl. (
B
) Clinical appearance after 11 separate laser treatments.
Source
: Photos
courtesy of Mitchel P. Goldman, MD.
