Clinical, Cosmetic and Investigational Dermatology (Mar 2023)
Efficacy of Fractional Carbon Dioxide (CO2) Laser versus Q-Switched Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) and Potassium-Titanyl-Phosphate (KTP) Lasers in the Treatment of Acanthosis Nigricans
Abstract
Maha Fathy Elmasry,1 Moemena Maher Fathi Khalil,2 Ashraf Badawi,3,4 Naglaa Sameh Zaki,1 Aya Fahim1 1Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt; 2Department of Dermatology, Quesna Central Hospital, Menofia, Egypt; 3Department of Medical Laser Applications, National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt; 4Department of Dermatology and Allergology, Faculty of Medicine, University of Szeged, Szeged, HungaryCorrespondence: Aya Fahim, Dermatology Department, Faculty of Medicine, Cairo University, Post office Box 109, El-Malek El-Saleh, Cairo, 11562, Egypt, Tel +202 01020279628, Email [email protected]: Acanthosis nigricans (AN) is a common chronic skin disorder clinically presents by velvety hyperpigmented lesions mainly at the flexural areas. Fractional photothermolysis has been reported to improve both pigmentary and textural changes by removing thin layers of skin with minimal thermal damage. Other options are the Q-switched (Qs) Nd:YAG (1064 nm) and Qs KTP (532 nm) lasers. Both can induce collagen remodeling by dermal photo-mechanical microdamage.Aim of the Work: The aim of this study was to assess the clinical efficacy and the safety of fractional CO2 laser versus Qs Nd:YAG and KTP lasers in the treatment of acanthosis nigricans.Methods: This randomized-controlled split neck study was conducted on 23 patients suffering from AN. For each patient, one side of the neck was randomly assigned to fractional CO2 laser and the other side to Qs Nd:YAG and KTP lasers every four weeks for four months followed by 4 monthly follow-up assessment. Acanthosis Nigricans Area and Severity Index (ANASI) score, melanin and erythema indices as well as Patient Satisfaction Scale (PSS) were used to assess improvement on each side separately.Results: There was no statistically significant difference regarding the clinical improvement between the side treated with Fractional CO2 laser and the side treated with Qs Nd:YAG and KTP lasers (P value > 0.05). In most patients, both sides showed improvement during different sessions of therapy, as regards ANASI scores, melanin indices, patient satisfaction scores, and side effects.Conclusion: In this study, we concluded that both fractional CO2 and Q-switched lasers proved to be a safe and effective line of treatment of acanthosis nigricans.Keywords: acanthosis nigricans, fractional CO2 laser, Q-switched Nd:YAG laser, ANASI score, Q-switched KTP laser
