MIAMI Laser treatment improved dermatosis papulosa nigra with efficacy comparable to standard electrodesiccation, according to rater assessments in a randomized, split-face pilot study of skin types IV-VI.
Subjective ratings, however, revealed a trend toward better efficacy with the laser treatment (Aura KTP [potassium titanyl phosphate], Laserscope) after 8 weeks, Dr. Roopal V. Kundu said at an international symposium sponsored by the L'Oréal Institute for Ethnic Hair and Skin Research.
"Both treatment modalities were quite efficacious; however, the KTP laser was probably preferable for patient comfort and tolerability," she said.
Dermatosis papulosa nigra (DPN) are superficial and hyperpigmented papules that occur on the head and neck of patients with darker skin. They tend to grow in size over time and do not resolve. Although benign, "they are cosmetically displeasing and psychologically distressing to many of our patients," said Dr. Kundu, who is with the department of dermatology at Northwestern University, Chicago, and has no financial disclosure regarding the KTP laser.
"The important point for dermatologists is we have a wonderful opportunity to educate patients with DPNs. Tell them they are not moles, that they are benign and have no malignant potential," she said.
Conventional treatment includes cryotherapy, snip excision, curettage, or electrodesiccation of each lesion. These approaches, however, increase the risk of pain and hypopigmentation, especially in darker skin.
All 14 participants were adults with clinically diagnosed DPN and skin types IV-VI. There were 11 women and 3 men with a mean age of 52 years. At baseline and 4 weeks, each received electrodesiccation to half of their face and KTP laser treatment to the other half. The laser was set to 15 J/cm2, 5 pulses per second repetition, and a 1-cm spot size.
A dermatologist blinded to the regimen rated left- and right-side photographs at week 8. Efficacy was rated as a score of 1-4, with each number representing a 25% clinical improvement over baseline. About 60% of photographs demonstrated a 75%-100% improvement, so the raters found no statistically significant difference between treatments.
"There was a notable improvement for both KTP laser treatment and electrodesiccation at week 8," Dr. Kundu said at the meeting, which was also sponsored by Howard University.
Participants were asked to report adverse events, treatment satisfaction, and cosmetic outcome up to week 8. They used a 1-5 rating scale, with 1 representing "not at all" and 5 "very much." There was a trend toward KTP laser treatment being more effective than electrodesiccation. In addition, there was significantly "less pain and discomfort with the KTP laser," Dr. Kundu said.