Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Lasers Surg Med. 2023 Aug;55(6):547-554. doi: 10.1002/lsm.23670. Epub 2023 Apr 23.
To assess the efficacy and safety of a 1927-nm fractional thulium fiber laser treatment for Becker's nevus.
A retrospective analysis of patients with Becker's nevus who were treated with a 1927-nm fractional thulium fiber laser was conducted. Grading for lightening was set quarterly by physician global assessment of the pre- and postphotographs (I: <25%; II: 25%-50%; III: 51%-75%; and IV: >75% for marked lightening). Grading validation was exercised using intra- and interobserver agreement analysis among 10 dermatologists to determine the percent of agreement and the intraclass correlation coefficient. Grades I and II were classified as treatment failure.
A total of 21 patients were recruited for analysis. The average number of treatment sessions was 2.1 per patient. A total of 13 patients achieved successful outcomes (grades III and IV) while 8 patients experienced treatment failure (grades I and II). Partial recurrence and transient hypopigmentation on adjacent skin were the main adverse effects. Only one patient reported worsening of the nevus. Overall agreement among the raters for the outcomes was graded from "very good" to "excellent," and the intraclass correlation coefficient, kappa, was 0.8.
A 1927-nm fractional thulium fiber laser may be effective to ameliorate the pigment of Becker's nevus and achieve acceptable cosmetic outcomes. However, further studies are required in this area to improve and optimize the results.
评估 1927nm 飞点铥光纤激光治疗贝克氏痣的疗效和安全性。
对接受 1927nm 飞点铥光纤激光治疗的贝克氏痣患者进行回顾性分析。根据治疗前后照片的医生总体评估（I 级：<25%；II 级：25%-50%；III 级：51%-75%；IV 级：>75%明显变浅），每季度对变浅程度进行分级。通过 10 名皮肤科医生的观察者内和观察者间一致性分析来验证分级的准确性，以确定一致性百分比和组内相关系数。将 I 级和 II 级归为治疗失败。
共纳入 21 例患者进行分析。每位患者的平均治疗次数为 2.1 次。13 例患者获得成功（III 级和 IV 级），8 例患者治疗失败（I 级和 II 级）。主要不良反应为局部复发和相邻皮肤短暂性色素减退。仅 1 例患者报告痣恶化。评估者对结局的总体一致性评为“很好”到“优秀”，组内相关系数 kappa 为 0.8。
1927nm 飞点铥光纤激光可能有效改善贝克氏痣的色素沉着，并获得可接受的美容效果。然而，该领域需要进一步研究以改善和优化结果。
