Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Lasers Surg Med. 2022 Sep;54(7):970-977. doi: 10.1002/lsm.23562. Epub 2022 Jun 7.
Laser hair removal (LHR) is a common practice with increasing use worldwide. Clinical and dermoscopic changes in melanocytic nevi after LHR have been reported but prospective studies are lacking.
To describe dermoscopic changes of melanocytic nevi at different time points after LHR.
Prospective study in a cohort of female patients undergoing diode LHR. Dermoscopic follow-up of at least three nevi on the legs that underwent hair removal. We included three nonexposed nevi on the arms as controls. Two blinded investigators analyzed dermoscopic images, according to variables selected based on the available literature.
Thirty-four patients were included with a total of 148 nevi on the legs and 112 nevi on the arms (controls). 47.9% (71/148) of the nevi on the legs had evidence of dermoscopic changes at the sixth hair removal session, compared to 9.8% (11/112) on controls (p < 0.001). The most frequent change was "bleaching" (41.9%, 62/148). Also, we observed "irregular hyperpigmented areas," and "regression structures" in 5.4% (8/148) and 4.7% (7/148) of the cases at the sixth session, respectively. Neither of these structures were observed in the controls (p < 0.05).
Only females were included; we did not perform histopathological evaluation nor reflectance confocal microscopy of changing nevi.
Melanocytic nevi frequently change after diode LHR. The changes cannot always distinguish between LHR induced and melanoma, so we advise avoiding nevi during laser therapies with melanin targets.
激光脱毛（LHR）是一种常见的做法，在全球范围内的应用越来越多。已有报道称，激光脱毛后黑素细胞痣的临床和皮肤镜学变化，但缺乏前瞻性研究。
描述 LHR 后不同时间黑素细胞痣的皮肤镜学变化。
对一组接受二极管 LHR 的女性患者进行前瞻性研究。对腿部接受脱毛的至少 3 个痣进行皮肤镜随访。我们将手臂上的 3 个未暴露的痣作为对照纳入。两名盲法观察者根据现有文献选择的变量分析皮肤镜图像。
共纳入 34 例患者，共 148 个腿部痣和 112 个手臂痣（对照组）。与对照组的 9.8%（11/112）相比，腿部的痣在第六次脱毛疗程中有 47.9%（71/148）出现皮肤镜学改变（p<0.001）。最常见的变化是“漂白”（41.9%，62/148）。此外，我们在第六次疗程中分别观察到 5.4%（8/148）和 4.7%（7/148）的病例中出现“不规则色素沉着区”和“退行性结构”。对照组均未观察到这些结构（p<0.05）。
仅纳入女性；我们未进行组织病理学评估，也未对变化中的痣进行反射共聚焦显微镜检查。
二极管 LHR 后黑素细胞痣常发生变化。这些变化不能总是区分 LHR 诱导的和黑色素瘤，因此我们建议在针对黑色素的激光治疗中避免使用黑素细胞痣。
