title: Carbon dioxide laser treatment of cutaneous neurofibromas.
abstract: BACKGROUND
  Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder, with multisystem involvement, including cutaneous manifestations of hyperpigmentation and neurofibromas. Multiple cutaneous lesions are often disfiguring and lead to emotional distress and social isolation. Treatment of NF1 is predominantly surgical but alternative treatments should be considered for patients with large numbers of lesions as cold steel excision of multiple lesions can be cumbersome and may not be practical. The authors report a series of patients with multiple neurofibromas successfully treated using a CO(2) laser.
  
  
  METHODS
  Data on CO(2) laser treatments, follow-up, and recurrence following treatment was collected retrospectively. A post-treatment telephone survey was carried out to assess patient satisfaction using a standardized set of questions and a scoring tool.
  
  
  RESULTS
  Five of seven patients who underwent CO(2) laser treatment of their multiple neurofibromas responded to the post-treatment survey. All five patients (age range 36-56 years, mean age 45.2 years, three men:two women) had multiple variable-sized neurofibromas. The mean number of lesions per patient was 114 (range 20-200 lesions). The mean number of treatment sessions was 2.2 (range 1-4 sessions) and mean follow-up was 14.4 months (range 6-24 months). Three patients (60%) reported no recurrence up to 2 years post-laser treatment. Two patients (40%) had recurrences of a few lesions (≤10% of treated lesions per patient). The mean patient satisfaction score was 9.2 out of 10 (range 8-10). All patients mentioned that they would recommend CO(2) laser treatment to others with multiple neurofibromas. Hypopigmentation or depigmentation at treatment sites were the only reported adverse effects.
  
  
  CONCLUSIONS
  Based on current results, the authors feel that CO(2) laser treatment achieves a high level of patient satisfaction with a low recurrence of treated lesions.
authors.affiliation: The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, UK.
authors.forename: Yi Zhen
authors.initials: YZ
authors.lastname: Chiang
authors.forename: Firas
authors.initials: F
authors.lastname: Al-Niaimi
authors.forename: Janice
authors.initials: J
authors.lastname: Ferguson
authors.forename: Paul Jeffrey
authors.initials: PJ
authors.lastname: August
authors.forename: Vishal
authors.initials: V
authors.lastname: Madan