Avaliação do laser Erbium : YAG na remoção dos nevos melanocíticos

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

Melanocytic nevi are commonly found in the population. They generally present a benign course but may reveal individuals with increased risk for melanoma or even suffer malignant transformation. They are frequently considered unattractive to look and patients often desire to treat them. The standard treatment of melanocytic nevi is the surgical removal. However, depending on its localization, extension and other factors, the surgery is accompanied of considerable risk or may lead to an unsatisfactory aesthetic result. Laser technology was developed more than forty years ago, since then a search for a Laser to treat melanocytic nevi started. The energy produced by Laser appliances is different from other forms of luminous energy because of the following properties: monochrome, coherence and collimation. These properties confer to the Laser a radiation of high intensity that acts specifically on its target. The first studies with ruby Laser had gotten clinical success however, the histopathologic exam revealed the permanence of nevi cells and pigment, what is undesirable due to the possibility of malignant transformation. The aim of this study was to verify the aesthetic and histopathologic results of melanocytic nevi treated with Er:YAG Laser. This is an ablative Laser that has the water as target. It is a safe and accurate method that vaporizes a fine layer of tissue at each application. Nine patients with acquired melanocytic nevus were selected to treat half of their lesions with Er:YAG Laser. The parameters used were: 12 shots with a fluency of 1200 mJ and a spot size of 4mm. After 30 days the entire lesion was removed for histopathologic study. Hematoxilin-eosin and Fontana-Masson preparations were used to verify the removal of nevi cells and pigment respectively. Despite the excellent aesthetic result and absence of complications, the histopathologic study showed the permanence of nevi cells and pigment in 7 and 9 of the samples examined respectively. This allowed us to conclude that the aesthetic result and the safety profile is good however, this method, with the parameters applied, is unable to completely remove the nevi cells and the pigment. Therefore this treatment can not be recommended for the treatment of acquired melanocytic nevi.

ASSUNTO(S)

nevo pigmentado medicina lasers na medicina melanócitos

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