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Nevi and lasers: Practical considerations
Tova Rogers1, Andrew C Krakowski2, Maria L Marino1
1Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Abstract:
Lasers are increasingly used for elective ablation of melanocytic nevi (MN). However, the associated risks of treating MN with lasers are debated and not well studied. Theoretical risks include inadvertently treating a melanoma mistaken for a nevus, the inability to remove all nevus cells and the possibility for residual cells to undergo malignant transformation, and the difficulty in clinically monitoring the remnant nevus for melanoma progression. Additional concerns include the morphological suitability of a lesion for laser removal and managing patients' expectations about the variable cosmetic outcomes. These potential issues have prompted us to outline some practical suggestions for clinicians and patients to consider when determining the suitability of a nevus for laser ablation. The choice to perform laser removal of a nevus is personal, both from the perspective of the treating physician and that of the person being treated. While acknowledging some uncertainty, we believe that these suggestions can help mitigate risk and improve patient outcomes. Lasers Surg. Med. 50:7-9, 2018. © 2017 Wiley Periodicals, Inc.
Insights
Laser ablation of melanocytic nevi (MN) carries debated risks, including misdiagnosis and incomplete removal. This study offers practical suggestions to mitigate risks and enhance patient outcomes for laser MN treatment.
Area of Science:
- Dermatology
- Laser Medicine
- Oncology
Background:
- Elective laser ablation for melanocytic nevi (MN) is increasing.
- Risks associated with laser MN treatment are not well-studied.
Discussion:
- Theoretical risks include misdiagnosing melanoma as nevus, incomplete nevus cell removal, and potential malignant transformation of residual cells.
- Challenges in monitoring residual nevi for melanoma progression and assessing lesion suitability for laser removal are significant.
- Managing patient expectations regarding variable cosmetic outcomes is crucial.
Key Insights:
- Laser ablation of melanocytic nevi presents potential risks that require careful consideration.
- Suggestions are provided for clinicians and patients to determine nevus suitability for laser ablation.
- Mitigating risks and improving patient outcomes are achievable through informed decision-making.
Outlook:
- Further research is needed to fully understand and quantify the risks of laser MN ablation.
- Standardized guidelines for nevus suitability assessment and patient counseling are recommended.
- Continued evaluation of long-term outcomes and potential complications is essential.
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