Acanthosis Nigricans Groin

Lasers

Laser Wavelengths

Laser

Wavelength

Target

Uses

Resurfacing Lasers

Carbon dioxide (CO2) laser

10,600 nm

Water

Resurfacing

Erbium:YAG laser

2940 nm

Water

Resurfacing; more superficial

Vascular Lesion Lasers

Argon*

488, 514 nm

Oxyhemo-globin

Telangiectases, thick port-wine stains, venous lesions; high risk of scarring

Argon-pumped tunable dye

585-690 nm

Oxyhemo-globin

Telangiectases, thick port-wine stains

Copper vapor, yellow*

578 nm

Oxyhemo-globin

Telangiectases, thick port-wine stains

Flashlamp pulsed dye

585, 595 nm

Oxyhemo-globin

Telangiectases, thin port-wine stains, cherry angiomas, childhood hemangiomas, warts, scars, striae, poikilo-derma of Civatte, leg veins

(Continued text on following page)

Laser Wavelengths (Continued)

Laser

Wavelength

Target

Uses

Krypton, yellow*

1568 nm

Oxyhemo-globin

Telangiectases, thin port-wine stains

Long-pulsed KTP

532 nm

Oxyhemo-globin

Facial telangiec-tases, leg veins

Long-pulsed Nd: YAG (safest in dark skin types)

1064 nm

Oxyhemo-globin

Lesion Lasers

Copper vapor, green*

511 nm

Melanin

Epidermal pig-mented lesions

Frequency-doubled Nd: YAG

532 nm

Melanin

Epidermal pigmented lesions, some red tattoos

Krypton, green*

521,531 nm

Melanin

Epidermal pigmented lesions

Hair Removal Lasers**

Alexandrite

755 nm

Melanin in hair

Hair removal

Diode

810 nm

Melanin in hair

Hair removal

Nd:YAG

1064 nm

Melanin in hair

Hair removal

Ruby

694 nm

Melanin in hair

Hair removal

(Continued text on following page)

Laser Wavelengths (Continued)

Laser

Wavelength

Target

Uses

Tattoo Lasers

Frequency-

532 nm

Tattoo pigment

Red tattoos

doubled Nd:

YAG

Q-switched

755 nm

Tattoo pigment

Black, blue, and

alexandrite

green tattoos

Q-switched

1064 nm

Tattoo pigment

Black and blue

Nd: YAG

tattoos

Q-switched

694 nm

Tattoo pigment

Black, blue, and

ruby

green tattoos;

Nevus of Ota

*These lasers are uncommonly used

**Only effective on darkly pigmented hair; blond or gray hair resists

treatment

N.B. #1: Q-switched technology allows higher energy & shorter pulses.

N.B. #2: New laser technology:

1. Excimer laser (308 nm): psoriasis, striae & vitiligo

2. 1450 diode or 1320 Nd:YAG laser: dermal collagen remodeling for

wrinkles and atrophic scars.

Seborrheic Dermatitis Stomach

Acanthosis Nigricans (AN)

Acanthosis Nigricans Warts Groin

Etiology: May be due to:

a. Heredity b. Endocrine disorder—most commonly associated with insulin resistance (i.e., diabetes mellitus), hyperandrogenic state, hypothyroidism c. Obesity d. Drugs—e.g., nicotinic acid, niacinamide, oral contraceptives, steroids e. Malignancy, usually adenocarcinoma—e.g., gastrointestinal (60% stomach), lung, breast

History: Rule out aforementioned causes.

Physical: Hyperpigmented velvety, typically symmetrical plaques predominantly on the neck, axillae, and groin.

Physical location & morphology may be similar for AN of different etiologies; hence, Hx and Px should aim to include/exclude these associated conditions.

DDx: Eczema (e.g., lichen simplex chronicus), hyperpigmented nevus (e.g., Becker, epidermal), confluent and reticulated papillomatosis of Gougerot and Carteaud

Investigations: Screen for diabetes (glycosylated Hgb) and insulin resistance (plasma insulin); consider searching for underlying malignancy in adult onset.

Management

■ Treat underlying disorder (e.g., remove tumor).

■ Cases associated with obesity and/or insulin resistance may improve with weight loss and/or metformin.

■ Management is difficult and mostly for cosmetic purposes.

■ Tx options:Topical tretinoin, ammonium lactate, laser therapy, dermabrasion.

Stretch Marks

Stretch Marks

Stretch Marks Prevention and Treatment. Learn What Exactly Are Stretch Marks And How Can They Be Treated. MP3 Audio included for your PC or IPod.

Get My Free Ebook and Audio


Post a comment