IngentaConnect Intense Pulsed Light Treatment of Persistent Facial Hypermelanosi...

Abstract:

Background.

Cutaneous hyperpigmentation is one of the most cosmetically disturbing sequel of drug-induced toxic epidermal necrolysis. Intense pulsed light is a promising tool for treating some melanocytic lesions. Objective.

The objective was to assess the effect of intense pulsed light in treating post-toxic epidermal necrolysis facial hypermelanosis. Methods.

Two Caucasian men aged 35 and 50 years presented with long-standing (32 and 39 years) severe hypermelanosis of the face after sulfonamide-induced toxic epidermal necrolysis. They were treated by intense pulsed light. Cutoff filters of 550, 590, and 615 nm were employed for five intense pulsed light sessions at 4-week intervals. The treatment was characterized by energy fluence of 25 to 32 J/cm ² , pulse width of 2.2 to 3.2 ms, and double- to triple-pulse mode respecting a 30-ms delay. Before intense pulsed light treatment, and 2 months after the fifth intense pulsed light session, clinical photographs and skin biopsies were performed in combination with quantitative narrow-band remittance spectrophotometry of melanin pigmentation. Patients were clinically followed-up for 8 months after the end of the treatment. Results.

In both patients, clinical, histologic, and spectrophotometric assessments showed an average of 80% decrease in the hypermelanosis. No clinical recurrence of the hypermelanosis developed during the 8-month follow-up after intense pulsed light treatment. No major persistent side effects were experienced, especially hypopigmentation. Conclusion.

Intense pulsed light appears to be effective and safe for treating post-toxic epidermal necrolysis hypermelanosis in Caucasian patients.

PHILIPPE PAQUET, MD, PHD, AND GÉRALD E. PIÉRARD, MD, PHD HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.

Intense Pulsed Light Treatment of Persistent Facial Hypermelanosis Following Drug-Induced Toxic Epidermal Necrolysis