Riehl Melanosis Treated Successfully With Q-switch Nd:YAG Laser

March 2014 | Volume 13 | Issue 3 | Case Reports | 356 | Copyright © March 2014


Joanne E. Smucker BSa and Joslyn S. Kirby MDb

aPenn State College of Medicine, Hershey, PA
bDepartment of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, PA

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sis with Qs FD Nd:YAG laser has not been documented. In a previous report, IPL using filters of 590, 640, and 694 had been used successfully to treat Riehl melanosis.6, 7 However, when a similar filter of 570nm was used for this patient she had no response using a setting of 16 joules and a severe response with blistering at 18 joules. Thankfully, a change to the Nd:YAG filter resulted in cosmetically acceptable improvement without adverse effects. Despite only treating a minority portion of her affected skin, the patient reported reduced pigmentation of all areas. It is possible that the laser therapy treated incited an immune response that resulted in improvement in her pigmentation or alternately treated a subclinical inflammatory process.
This case reports the successful treatment of Riehl melanosis with a Qs FD Nd:YAG following failure of IPL therapy. This modality should be considered for the treatment of this unusual pigmented dermatosis.

DISCLOSURES

The authors have no relevant conflicts to disclose.

REFERENCES

  1. Riehl G. Ueber eine eigenartige Melanose. Wien Klin Wochenschr. 1917;30:780.
  2. Rorsman H. Riehl’s melanosis. Int J Dermatol. 1982;21(2):75-8.
  3. Seike M, Hirose Y, Ikeda M, et al. Coexistence of Rieh’s melanosis and lichen planus. J Dermatol. 2003 Feb;30(2):132-4.
  4. Park J, Kim Y, Lee E, et al. Acquired bilateral melanosis of the neck in perimenopausal women. Br J Dermatol. 2012 March;166(3):662–665.
  5. Khane N, Rasool S. Facial melanoses: Indian Prospective. Indian J Dermatol Venereol Leprol. 2011;77(5):552-563.
  6. Oiso N, Daisuke T, Imanishi H, et al. The effectiveness of intense pulsed light for possible Riehl’s melanosis. Dermatol Ther. 2010;23:561-563.
  7. Li YH, Liu J, Chen J, et al. A Pilot Study of Intense Pulsed Light in the Treatment of Riehl’s Melanosis. Dermatol Surg. 2011;37:119-122.
  8. Nelson AA, Lask GP. Principles and practice of cutaneous laser and light therapy. Clin Plast Surg. 2011;38(3):427-36.

AUTHOR CORRESPONDENCE

Joslyn S. Kirby MDJkirby1@hmc.psu.edu
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