PDF(Pubmed)
Abstract：
Atypical clinical and dermoscopic findings, or changes in pigmented melanocytic lesions located on body areas treated with lasers or intense pulsed light (IPL) for hair removal (photoepilation), have been described in the literature. There are three prospective studies in a total of 79 individuals with 287 melanocytic nevi and several case reports reporting the dermoscopic findings and changes after photoepilation. Clinical changes have been reported in 20-100% of individuals, while dermoscopic changes have been observed in 48% to 93% of nevi. More frequent dermoscopic changes included bleaching, the development of pigmented globules, and irregular hyperpigmented areas and regression structures, including gray areas, gray dots/globules, and whitish structureless areas. The diagnostic approach for pigmented lesions with atypical dermoscopic findings and changes after photo-epilation included reflectance confocal microscopy, sequential digital dermoscopy follow-up, and/or excision and histopathology. Challenges pertaining to these diagnostic steps in the context of photoepilation include the detection of findings that may warrant a biopsy to exclude melanoma (ugly duckling, irregular hyperpigmented areas, blue-gray or white areas, and loss of pigment network), the potential persistence of changes at follow-up, and that a histopathologic diagnosis may not be possible due to the distortion of melanocytes or complete regression of the lesion. Furthermore, these diagnostic approaches can be time-consuming, require familiarization of the physician with dermoscopic features, may cause anxiety to the individual, and highlight that avoiding passes of the laser or IPL devices over pigmented lesions is key.
摘要：
不典型的临床和皮肤镜检查结果，或位于用激光或强脉冲光（IPL）进行脱毛（光脱毛）治疗的身体区域的色素黑素细胞病变的变化，已在文献中描述。共有三项前瞻性研究，共79例，有287个黑素细胞痣，一些病例报告报告了光脱毛后的皮肤镜发现和变化。据报道，20-100％的个体发生了临床变化，而在48％至93％的痣中观察到皮肤镜变化。更频繁的皮肤变化包括漂白，色素球的发育，不规则的色素沉着区域和回归结构，包括灰色地带,灰点/小球，和白色的无结构区域。具有不典型的皮肤镜检查结果和光脱毛后变化的色素性病变的诊断方法包括反射共聚焦显微镜，顺序数字皮肤镜随访，和/或切除和组织病理学。在光脱毛的背景下，与这些诊断步骤有关的挑战包括检测可能需要进行活检以排除黑色素瘤（丑小鸭，不规则的色素沉着区，蓝灰色或白色区域，和色素网络的损失)，后续变化的潜在持久性，并且由于黑素细胞的扭曲或病变的完全消退，可能无法进行组织病理学诊断。此外，这些诊断方法可能很耗时，需要医生熟悉皮肤镜特征，可能会给个人带来焦虑，并强调避免激光或IPL设备越过色素病变是关键。
