Q-switched Nd:YAG Laser for Extrafacial Lichen Planus Pigmentosus: A Case Series Highlighting Outcomes and Risks.
Danny Linggonegoro, Tarek Bandali, Nour Kibbi
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Case in brief
Three patients with biopsy-proven lichen planus pigmentosus (LPP) involving facial and extrafacial sites received Q-switched neodymium:yttrium aluminum garnet laser treatment. Facial LPP improved in all patients, whereas responses on the neck, shoulders, and trunk varied. One patient developed Koebnerized vitiligo after treatment to the neck. The report describes potential benefit alongside site-dependent outcomes and a treatment-associated complication; it does not provide further details on the course or resolution of the vitiligo.
What made this case unusual
A patient developed Koebnerized vitiligo after laser treatment of neck LPP, highlighting a potential complication in someone with underlying or suspected vitiligo.
Diagnostic / clinical pearl
Laser response in these cases differed by site: facial LPP improved in all patients, but extrafacial outcomes were variable. Consider the reported vitiligo risk when treating patients with underlying or suspected vitiligo.
Why it matters
The authors suggest lower-fluence approaches may offer a safer alternative for sensitive areas, while emphasizing that extrafacial treatment outcomes and risks may differ from facial treatment.