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Comparing the efficacy of pulsed dye laser, Q-Switched Nd-YAG, CO2, and combined CO2 and Q-Switched Nd-YAG lasers for the treatment of cutaneous macular amyloidosis

Abstract Background No topical and systemic treatment is proven to be effective on Cutaneous Macular Amyloidosis (CMA). The physical removal of the deposited protein by lasers may be a better choice. Objective To compare the efficacy of different lasers including Pulsed dye laser (PDL), 1064 mode of Q-Switched Nd-YAG, CO2, and combined CO2 and Q-Switched Nd:YAG lasers for the treatment of CMA. Patients and Method 17 adult female patients with clinical CMA and histopathological confirmation were included in this study. Four close 1 by 1 cm2 areas were treated simultaneously with PDL, Q-Switched Nd-YAG, CO2 and combined CO2 and Nd-YAG Lasers. The energy used for 585 nm PDL were 9 J/cm2 with the spot size of 5 mm. The energy used for 1064 nm mode of Nd-YAG laser was 5 Joules/cm2, with the spot size of 4 mm, and the frequency of 10 hertz. The energies used for CO2 laser were 4 and 3.5 Micro Joules for the first and second Passes. Results No desirable result obtained after PDL therapy. The Q-Switched Nd-YAG was effective in only 3 patients. All areas treated with CO2 laser were cleared. Conclusion The CO2 laser is seems to be the most effective laser treatment of CMA.