Bilateral nevus of Ota series treated with picosecond laser

Nevus of Ota (NO) "oculodermal melanocytosis" is prevalent in Asians. Bilateral nevus of Ota (BNO) is a rare condition and comprises 5% of the cases seen. Picosecond laser (PS) is useful in treating various cutaneous benign pigmentary disorders including NO. We analyzed the clinical data on BNO in Vietnamese patients and evaluated the efficacy of treatment of the 1064 nm Nd:YAG picosecond laser (PSNY).

Twenty-nine Vietnamese patients (ages 2-67 years, mean 23.36 ± 17.5) with BNO received at least 3 treatment sessions with 1064-nm PSNY (4-5 mm spot size; 1.5-2.4J/cm², 4-week intervals). Improvement was documented through serial photographs that were taken at baseline (T0), after 4 weeks of the 3^rd session (T1), 6^th session (T2), 9^th session (T3), and more than 10 sessions (T4). Response to the treatment was graded based on a 5-point grading scale.

The participants were predominantly female (23 females, 6 males). Sclera, nasal mucosa, and pharyngeal NO lesions were observed in 24 patients (51.7%, 69%, and 6.9%, respectively). Two cases (6.89%) had lesions combined with Port-Wine-Stains. In the majority of cases, more than two branches of the trigeminal nerve were involved (89.66%). Onset of the lesions at <10 years old was 69% and involvement of more than two branches of the trigeminal nerve in these patients was 89.66%. Overall, 100% of patients demonstrated an improvement of the BNO lesions following treatment. A total of 88.9% of patients demonstrated a score compatible with good improvement to complete clearance after 9 treatment sessions on the treatment scoring scale. No severe adverse events or complications were observed. The 1064-nm PSNY laser has the potential to achieve faster clearance for treating dermal pigmentary disorders in Asians. To our knowledge, this is the largest reported series of BNO treated with a laser.

Our results suggest that 1064-nm PSNY laser treatment is efficacious and an appropriate therapeutic modality for the treatment of BNO with minimal downtime and minimal adverse side effects.