Abstract

Objectives: 1. Differential diagnosis and dermoscopic features of solar lentigines 2. Proper end-point of 532nm laser treatment 3. Post-laser care for prevention of post-inflammatory hyperpigmentation Introduction: Solar lentigo commonly occurs as hyperpigmented macules in areas exposed to ultraviolet radiation. It typically shows an increased number of melanocytes in the basal cell layer of the skin, with or without elongated rete ridges. In Asians, solar lentigines present a challenge to physicians due to excessive post-inflammatory hyperpigmentation(PIH) following laser removal. Materials / method: I conducted a retrospective analysis of cases of solar lentigines treated with Q-switched 532nm Nd:YAG. I aimed to evaluate the effectiveness and PIH after laser. Results: Patient selection is the most important factor in removing solar lentigines with laser, and the use of dermoscopy is helpful. Q-switched 532nm Nd:YAG laser treatment is important to create small blisters between the lesion and non-lesion areas, like the sugar honeycomb challenge in the K-drama Squid Game. Afterwards, the use of medication and occlusive dressings are very important to reduce PIH. Conclusion: Laser treatment of solar lentigines with sugar honeycomb challenge technique and occlusion dressing is a very effective method with few side effects in Asians. I would like to share my experience of reducing PIH while completely removing solar lentigines with a conventional 532nm Q-switched Nd:YAG laser over several years.