Zhang Aurore D, Clovie Janelle, Lazar Michelle, Vashi Neelam A
Department of Dermatology, Boston University School of Medicine, 609 Albany St., J502, Boston, MA 02118, USA.
Dermatology Institute of Boston, Boston, MA 02118, USA.
J Clin Med. 2025 Jun 5;14(11):3985. doi: 10.3390/jcm14113985.
Lasers are widely employed in the treatment of melanocytic lesions. This scoping review evaluates 77 studies on the efficacy and safety of laser treatments for café-au-lait macules (CALMs), nevus of Ota (NOA), Becker's nevus (BN), lichen planus pigmentosus (LPP), and other pigmented lesions. The Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG), particularly the 1064 nm, is the most frequently utilized laser, demonstrating strong efficacy for NOA and other dermal pigmentary disorders. Medium-wavelength lasers, including the Q-switched ruby and Alexandrite lasers, also show promise, though results vary based on lesion depth, skin type, and treatment protocols. Recurrence and adverse effects, including post-inflammatory hyperpigmentation (PIH) and hypopigmentation, are common, particularly in patients with darker skin tones. Future studies should standardize and optimize laser parameters across lesion types and skin tones, improve long-term efficacy, and prioritize inclusion of patients with diverse Fitzpatrick skin types to evaluate differential outcomes and promote equitable treatment efficacy.
激光广泛应用于黑素细胞性病变的治疗。本综述性研究评估了77项关于激光治疗咖啡斑（CALMs）、太田痣（NOA）、贝克痣（BN）、色素性扁平苔藓（LPP）及其他色素沉着性病变的疗效和安全性的研究。调Q掺钕钇铝石榴石（Nd:YAG）激光，尤其是1064nm波长的激光，是最常使用的激光，对太田痣和其他真皮色素沉着性疾病显示出强大的疗效。中波长激光，包括调Q红宝石激光和翠绿宝石激光，也显示出前景，不过结果因病变深度、皮肤类型和治疗方案而异。复发和不良反应，包括炎症后色素沉着（PIH）和色素减退，很常见，尤其是在肤色较深的患者中。未来的研究应针对不同病变类型和肤色规范并优化激光参数，提高长期疗效，并优先纳入不同菲茨帕特里克皮肤类型的患者，以评估不同的结果并促进公平的治疗效果。
