title: The effect of combination treatment of the recalcitrant pigmentary disorders with pigmented laser and chemical peeling.
abstract: BACKGROUND
  The pigmentary disorders including melasma, freckles, postinflammatory hyperpigmentation, or acquired bilateral nevus of Ota-like macules, etc. are usually resistant to all treatment modalities, and are therefore very frustrating to the patient and clinician.
  
  
  OBJECTIVE
  The purpose of this study was to demonstrate the effect of the combination treatment of recalcitrant pigmentary disorders with pigmented laser and chemical peeling and to observe any side-effects.
  
  
  METHODS
  Twenty-four patients with recalcitrant facial pigmentary disorders were treated with the Q-switched alexandrite laser at fluences of 7.0-8.0 J/cm2 or the pigmented lesion dye laser (PLDL) at fluences of 2.0-2.5 J/cm2, and at the same session, 15-25% trichloroactic acid (TCA) with or without Jessner's solution were used for the chemical peeling. And the results were clinically analyzed.
  
  
  RESULTS
  In the assessment by the patients, 63% of them considered the result as "clear, excellent, or good" in respect to the color and 54% of them assessed that the size of the lesion had cleared more than 50%. In the assessment by a clinician, 67% of the patients were categorized into the grade of clear, excellent, or good. There were no significant complications with this combination method.
  
  
  CONCLUSIONS
  The combination treatment with pigmented laser and chemical peeling is effective, safe, and relatively inexpensive treatment modalities in the recalcitrant pigmentary disorders.
authors.affiliation: Department of Dermatology, College of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Ga-Young
authors.initials: GY
authors.lastname: Lee
authors.forename: Hyun-Joo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kyu-Kwang
authors.initials: KK
authors.lastname: Whang
mesh_terms: D000328:Adult; D000368:Aged; D002615:Chemexfoliation; D003131:Combined Modality Therapy; D005148:Facial Dermatoses / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014238:Trichloroacetic Acid / Q000627:therapeutic use*
chemical_list: D014238:Trichloroacetic Acid