title: Non-ablative 1550 nm fractional laser therapy not effective for erythema dyschromicum perstans and postinflammatory hyperpigmentation: a pilot study.
abstract: BACKGROUND
  Erythema dyschromicum perstans and postinflammatory hyperpigmentation (PIH) are characterized by papillary dermal pigmentation or pigment incontinence. To date, no standard treatment is available. Fractional laser therapy (FLT) was recently reported to improve different pigment disorders.
  
  
  OBJECTIVE
  To assess the efficacy and safety of non-ablative FLT in the treatment of erythema dyschromicum perstans and PIH.
  
  
  METHODS
  Eight patients with erythema dyschromicum perstans and six patients with PIH were included. In each patient, two similar test regions were randomized to receive either five fractional laser treatments in combination with intermittent daily topical bleaching or the same intermittent regimen of topical bleaching alone. Three months after the last treatment, improvement of hyperpigmentation was assessed by melanin index, reflectance spectroscopy, physician's assessment, patient's assessment and patient's satisfaction. In addition, a biopsy of both laser treated and control site was evaluated by an independent blinded pathologist.
  
  
  RESULTS
  No clinical improvement of hyperpigmentation was observed. Reflectance spectroscopy, melanin index, number of melanocytes and amount of dermal melanin did not significantly differ. Patients considered FLT unsatisfactory. Moreover, three patients developed laser-induced PIH.
  
  
  CONCLUSIONS
  With these specific laser settings, non-ablative FLT was not effective for the treatment of erythema dyschromicum perstans and PIH.
authors.affiliation: Netherlands Institute for Pigment Disorders, Academic Medical Centre, University of Amsterdam, NL-1105AZ Amsterdam, The Netherlands. m.w.kroon@amc.uva.nl
authors.forename: Marije W
authors.initials: MW
authors.lastname: Kroon
authors.forename: Bas S
authors.initials: BS
authors.lastname: Wind
authors.forename: Arne A
authors.initials: AA
authors.lastname: Meesters
authors.forename: Albert
authors.initials: A
authors.lastname: Wolkerstorfer
authors.forename: J P Wietze
authors.initials: JP
authors.lastname: van der Veen
authors.forename: Jan D
authors.initials: JD
authors.lastname: Bos
authors.forename: Allard C
authors.initials: AC
authors.lastname: Van der Wal
authors.forename: Johan F
authors.initials: JF
authors.lastname: Beek
mesh_terms: D000328:Adult; D004890:Erythema / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology / Q000473:pathology / Q000532:radiotherapy*; D007249:Inflammation / Q000150:complications; D053685:Laser Therapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016037:Single-Blind Method; D055815:Young Adult