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Introduction: Wilson’s disease is a rare autosomal recessive disorder that disrupts copper metabolism. It presents with distinctive ocular manifestations. Oculodermal melanosis, commonly referred to as nevus of Ota, is a painless condition characterized by hyperpigmentation in and around the eye. In this case report, we describe the unique occurrence of both conditions in this pediatric patient. Case Presentation: A 10-year-old girl exhibited classic ocular signs associated with Wilson’s disease, including Kayser-Fleischer rings and sunflower-type cataracts. Additionally, she displayed unilateral confluent gray-blue hyperpigmentation consistent with a nevus of Ota. As of now, the patient remains asymptomatic, with preserved visual acuity. Conclusions: To the best of our knowledge, this case represents the first report of nevus of Ota in a child diagnosed with Wilson’s disease. [ABSTRACT FROM AUTHOR]

Introduction: Wilson’s disease is a rare autosomal recessive disorder that disrupts copper metabolism. It presents with distinctive ocular manifestations. Oculodermal melanosis, commonly referred to as nevus of Ota, is a painless condition characterized by hyperpigmentation in and around the eye. In this case report, we describe the unique occurrence of both conditions in this pediatric patient. Case Presentation: A 10-year-old girl exhibited classic ocular signs associated with Wilson’s disease, including Kayser-Fleischer rings and sunflower-type cataracts. Additionally, she displayed unilateral confluent gray-blue hyperpigmentation consistent with a nevus of Ota. As of now, the patient remains asymptomatic, with preserved visual acuity. Conclusions: To the best of our knowledge, this case represents the first report of nevus of Ota in a child diagnosed with Wilson’s disease.

Ji-Cong Jiang,&ast; Ying-Wei Wang,&ast; Yu Gao, Qi-Shuang Zhou Department of Dermatology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325027, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qi-Shuang Zhou; Yu Gao, Email 15258672597@163.com; gaoyu0570@sina.comBackground and Objective: Nevus of Ota (NO), also known as “brownish-blue nevus of the palate of the eye”, is a benign dermal pigmentation that increases skin disease. The Q-switched ruby laser is a classic treatment for nevus of Ota in children, but the optimal age for treatment is still controversial. The aim of this study was to investigate the treatment effect of Q-switched ruby laser in children with nevus of Ota at different ages and the effect on psychological health status.Materials and Methods: Children with nevus of Ota treated with Q-switched ruby laser in the Department of Dermatology of the Second Affiliated Hospital of Wenzhou Medical University from June 2015 to June 2019 were retrospectively analysed. And the mental health status was assessed using the CDI scale.Results: In the preschool children group (0– 7 year age), the significant efficacy rates was 93.1%, the average number of treatments was 3.6, and the overall incidence of adverse reactions was 4.7%. The significant efficacy rates in the school-age children group (7– 14 year age) was 90.3%, the average number of treatments was 5.1, and the overall incidence of adverse reactions was 13.7%. The mean post-treatment CDI score in the preschool children group was 10.8, and 9.7% of children exceeding 19 points. The mean pre-treatment CDI score in the school-age children group was 17.3, and 24.6% of children exceeding 19 points. The mean post-treatment CDI score was 13.6 and 15.1% of children exceeded 19 points. The chi-square test for the significant efficacy rate of the two groups showed P> 0.05, which was not statistically significant. The significant efficacy rate of the preschool group and that of the school-age children group. The t-test for the number of treatments in the two groups showed P< 0.05, which was statistically significant. Adverse reactions in the two groups showed a statistically significant P< 0.05. The mean CDI scores and the percentage of depressed individuals in the school-age children group were significantly lower after treatment than before treatment (p< 0.05).Conclusion: Q-switched ruby laser is safe and effective in treating nevus of Ota in children. Early treatment can reduce the number of treatments and the incidence of adverse reactions. In addition, early treatment can reduce children’s depression, which is beneficial to mental health.Keywords: nevus of Ota, children, Q-switched ruby laser, early treatment, mental health

We report a rare case of large facial hyperpigmentation in a 25-year-old female. Starting one month after birth, the patient developed a blue-brown patch on the right side of her face, interspersed with black macules and papules. As she aged, the lesion progressively enlarged and darkened, eventually covering the entire right side of her face. Dermoscopic and reflectance confocal microscopy examinations indicated nevus spilus in some areas and nevus of Ota in others, leading to a definitive diagnosis of overlapping nevus spilus and nevus of Ota. With no signs of malignant transformation on clinical or imaging examination, successful treatment was achieved using Q-switched alexandrite laser without any adverse effects. Our case underscores the critical value of dermoscopy and reflectance confocal microscopy in diagnosing rare facial pigmentary conditions, as we compare the imaging characteristics of nevus spilus, nevus of Ota, and similar conditions, alongside their clinical and histopathological correlations. Furthermore, our findings highlight the significant role of imaging examinations in monitoring malignancy and guiding treatment decisions.

The heightened awareness of ethnic dermatology aligns with the growing prevalence of skin of color communities globally, where hyperpigmentation disorders pose a common dermatological challenge. Effectively addressing dermal pigmentation is challenging due to its resistance to conventional therapies and its association with impaired quality of life. This underscores the need for effective treatments and a thorough grasp of laser advancements. A relevant literature search spanning the last 7 years across the PubMed database reveals core studies, challenges, and the evolution of laser technologies tailored for various forms of congenital and acquired dermal hyperpigmentation in skin of color. This comprehensive review explores the mechanisms, applications, and recommendations for pigmentary laser technologies, highlighting the key role of Q-switched lasers in their established millisecond/ nanosecond forms and emerging picosecond lasers, fractional non-ablative and ablative lasers, Intense Pulsed Light, etc. The summary of evidence includes studies on dermal melanocytosis (nevus of Ota and Hori's nevus), tattoos, acquired dermal macular hyperpigmentation, etc., and also entities with mixed epidermal–dermal components, such as melasma and post-inflammatory hyperpigmentation. The review offers valuable insights for clinicians to make informed decisions based on diagnosis, skin type, and the latest technologies to optimize results and minimize complications, especially in darker Fitzpatrick skin types. In their five-year study with 122 Indian patients, the authors applied specific laser combinations for diverse dermal melanoses, including tattoos, dermal/mixed melasma, acquired dermal macular hyperpigmentation, and dermal nevi. Substantial pigmentation reduction, subjectively assessed by both physicians and patients, was observed across all groups. A one-way ANOVA indicated a significant difference in mean improvement scores across various pigmentary conditions (F = 3.39, p = 0.02), with melasma patients exhibiting a significantly higher improvement score than tattoos (p = 0.03). The results affirmed the safety and efficacy of sequential laser therapy for dermal pigmentation in skin of color, advocating for flexibility in approach while maintaining the rationale behind the laser sequences. Despite advancements, challenges persist, and gaps in the current literature are identified. In conclusion, this summary highlights the ongoing pursuit of optimal protocols in dermatological laser treatments for dermal melanoses, offering valuable insights for future research and clinical practice. [ABSTRACT FROM AUTHOR]

Han Zheng, Ai-E Xu, Gang Qiao, Xiao-Yu Sun, Jia Deng, Yong Zhang Laser Center, Hangzhou Third People’s Hospital, Zhejiang, 310009, People’s Republic of ChinaCorrespondence: Han Zheng, Laser Center, Hangzhou Third People’s Hospital, No. 38 West Lake Avenue, Hangzhou, 310009, People’s Republic of China, Tel +86-13958159341, Email zhenghanzz98@outlook.comBackground and Aim: There is a dearth of scholarly investigation pertaining to the effectiveness and safety of laser therapy for nevus of Ota manifestation in infants. The objective of this study is to examine the efficacy and safety of administering laser therapy at an early stage to treat nevus of Ota in infants.Methods: A total of 102 infants below the age of one who had nevus of Ota were treated at the Laser Center at Hangzhou Third People’s Hospital. The treatment approach involved a combination of the Q-switched laser (with a wavelength of 755 nm) and the Q-switched laser (with a wavelength of 1064 nm). The treatment sessions were conducted at six-month intervals. Prior to and after each session, photographs and relevant parameters were documented, including any skin reactions. Subsequent follow-up was conducted through phone calls, WeChat, and text messages, and the parents/guardians of the infants completed a general questionnaire as well as Conner’s Abbreviated Symptom Questionnaire.Results: Laser therapy exhibited significant efficacy in the treatment of nevus of Ota in infants. Success rates reached 88.7% after four sessions and 99.3% after seven sessions. No instances of serious adverse reactions, except for pain, were reported. Among the 47 infants subject to follow-up, 14 experienced a recurrence, resulting in a recurrence rate of 29.8%. Factors contributing to these recurrences included lesion size, subtypes, exposure to the sun, and location. Subsequent laser treatments, typically involving two to three additional sessions, proved effective in mitigating recurrences. Notably, none of the infants exhibited any signs of fear, anxiety, or other psychological abnormalities following laser therapy, and the overall satisfaction rate was markedly high.Conclusion: Commencing laser therapy promptly for nevus of Ota in infants is recommended. This early intervention significantly contributes to the overall well-being of infants, addressing both physical and psychological aspects.Keywords: infants, laser, nevus of Ota, psychology, Q755, Q1064

Background and Design: Nevus of Ota is a hamartoma that present since birth or within the first year of life. Most patients suffer from depression, and laser has become the first-line treatment for this difficult-to-treat condition. There are hardly any studies regarding dermoscopic changes of the Nevus of Ota treated with Nd: YAG laser from Eastern India. This study aimed to evaluate the effectiveness, safety and side effects of 1064 nm Q-button Nd: YAG laser treatment together with dermoscopic changes in patients with Nevus of Ota. Materials and Methods: This was a prospective observational descriptive study conducted for a period of one year in a tertiary care hospital. We included clinically diagnosed Nevus of Ota patients aged over 18 years. Exclusion criteria were acute infection or chronic diseases, pregnancy or lactation, and history of any treatment with laser or chemo-peeling. Thirty-two cases were included in the study. Photographs and dermoscopic examinations were done at every session for an average of six sessions at an interval of four to six weeks. The response to treatment was graded based on the physician's global assessment scale, and appropriate statistical tests were done using SPSS 18. Results: Very good results with >75% improvement were seen in 12.5% of patients, and a good response i.e., 50-74% was seen in 59.37% of patients. An average response (25-49%) was seen in 18.75% of patients, while a poor response with

Background and Design: Nevus of Ota is a hamartoma that present since birth or within the first year of life. Most patients suffer from depression, and laser has become the first-line treatment for this difficult-to-treat condition. There are hardly any studies regarding dermoscopic changes of the Nevus of Ota treated with Nd: YAG laser from Eastern India. This study aimed to evaluate the effectiveness, safety and side effects of 1064 nm Q-button Nd:YAG laser treatment together with dermoscopic changes in patients with Nevus of Ota. Materials and Methods: This was a prospective observational descriptive study conducted for a period of one year in a tertiary care hospital. We included clinically diagnosed Nevus of Ota patients aged over 18 years. Exclusion criteria were acute infection or chronic diseases, pregnancy or lactation, and history of any treatment with laser or chemo-peeling. Thirty-two cases were included in the study. Photographs and dermoscopic examinations were done at every session for an average of six sessions at an interval of four to six weeks. The response to treatment was graded based on the physician's global assessment scale, and appropriate statistical tests were done using SPSS 18. Results: Very good results with >75% improvement were seen in 12.5% of patients, and a good response i.e., 50-74% was seen in 59.37% of patients. An average response (25-49%) was seen in 18.75% of patients, while a poor response with <25% improvement was found in 9.37% of patients. After completion of laser sessions, dermoscopy was done again to compare changes, but there were no significant changes except a slight lightening of the brown-grey patchy distribution and fewer brown-grey dots. There were no changes in terminal hair, serpentine vessels, and scaling. Conclusion: Most patients noted satisfying improvement after an average of six sessions of Nd: YAG laser therapy. Studies with a greater number of sessions can be conducted, and they may yield more improvement. [ABSTRACT FROM AUTHOR]

Nevus of Ota is a dermal melanocytic hamartoma clinically characterized by confluence of blue-to-gray macules, distributed along the ophthalmic and the maxillary divisions of the trigeminal nerve. It is usually unilateral and only 5–15% of cases have been reported to have bilateral involvement. This entity has been reported predominantly in darkly pigmented individuals, particularly in Asians and blacks. Case reports and case series describing this unique entity are very rare in literature. Herein, we report three cases of bilateral nevus of Ota at a tertiary care center in Eastern India. A detailed history, clinical examination, Wood’s lamp examination, and histopathological correlation were done in all the cases. In all the cases, lesions started with bluish pigmentation on the sclera and out of three cases, two had palatal involvement as well.

A 36-year-old female presented with brown patches on the left face, shoulder and chest for over 10 years. Dermatological examination showed a bluish-grey patch sized 11×5 cm around the left eye and brown patch on the sclera of the left eye. Demarcated bluish macules without scales and ulcers were seen on the left shoulder, upper limb and chest. Histopathological changes included well-defined masses of melanocytes and oval or spindle melanocytes in the dermis of sample from the left chest, scattered infiltrates of pigment-rich melanocytes paralleled to the epidermis of the sample from the left shoulder.Diagnosis: ipsilateral Nevi of Ota and Ito with multiple blue nevi. The blue nevi on the left chest wall and the nevus of Ito on the left shoulder were surgically removed. No recurrence occurred during one-year follow-up. The patient refused the treatment for nevus of Ota on the face.

A nevus is characterized by collection of partially differentiated or well-differentiated cells normally found in the skin. Some nevi are associated with disorders such as autism, epilepsy, ophthalmogical disorders, intracranial abnormalities, and others. In this case series, we aim to analyze six cases with congenital nevus, matched our findings with case reports published and reviewed the literature, to come to a conclusion that would help the clinician to do focused clinical examination and investigations when they come across such nevi. Furthermore, as these sort of skin lesions cause psychological morbidity to both parents and patients, proper counseling is required along with dermatological therapy and treatment of comorbid conditions. As well as regular follow-up with monitoring of the lesions. The following are the cases: Case-1, is a case of congenital melanocytic nevi who presented with delayed milestone, epilepsy and neuroimaging revealed intracranial melanosis. Case-2 nevus of Ota on face with scleral nevus and glaucoma in the left eye. In Case-3: Nevus achromicus was present over the abdomen and scalp in a child who presented with status epilepticus and there was focal cortical dysplasia of left frontal cortex on imaging. Nevus sebaceous was present in case-4 who had seizure disorder but neuroimaging was normal. Case-5 child had nevus spilus over left frontal area with melanocytic satellite nevi who presented with febrile convulsion but normal neuroimaging. The sixth case is a 5-year-old male child with linear nevus without any other association.

Nevus of Ota is a dermal melanocytic hamartoma clinically characterized by confluence of blue-to-gray macules, distributed along the ophthalmic and the maxillary divisions of the trigeminal nerve. It is usually unilateral and only 5–15% of cases have been reported to have bilateral involvement. This entity has been reported predominantly in darkly pigmented individuals, particularly in Asians and blacks. Case reports and case series describing this unique entity are very rare in literature. Herein, we report three cases of bilateral nevus of Ota at a tertiary care center in Eastern India. A detailed history, clinical examination, Wood’s lamp examination, and histopathological correlation were done in all the cases. In all the cases, lesions started with bluish pigmentation on the sclera and out of three cases, two had palatal involvement as well. [ABSTRACT FROM AUTHOR]

A 36-year-old female presented with brown patches on the left face, shoulder and chest for over 10 years. Dermatological examination showed a bluish-grey patch sized 11×5 cm around the left eye and brown patch on the sclera of the left eye. Demarcated bluish macules without scales and ulcers were seen on the left shoulder, upper limb and chest. Histopathological changes included well-defined masses of melanocytes and oval or spindle melanocytes in the dermis of sample from the left chest, scattered infiltrates of pigment-rich melanocytes paralleled to the epidermis of the sample from the left shoulder. Diagnosis: ipsilateral Nevi of Ota and Ito with multiple blue nevi. The blue nevi on the left chest wall and the nevus of Ito on the left shoulder were surgically removed. No recurrence occurred during one-year follow-up. The patient refused the treatment for nevus of Ota on the face. [ABSTRACT FROM AUTHOR]

Background: Nevus of Ota is a facial dermal melanocytic hamartoma occurring more commonly in Asians. The mainstay of treatment is 1064-nm Q-Switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, which has shown variable results in pigmented skin. Objective: The aim of this study was to determine whether Q-Switched Nd:YAG laser treatment combined with fractional CO2 laser is more efficacious than Q-Switched Nd:YAG laser alone. Materials and Methods: This was a prospective study with 81 patients. The patients were randomly divided into two groups. Group 1 received 1064-nm Q-Switched Nd:YAG laser alone and group 2 in addition received a fractional CO2 laser as well. Both groups received six sittings at monthly intervals. The treatment response was documented with physician global assessment (PGA) and patient's treatment satisfaction on Wong-Baker Facial Pain Scale (WBFPS). Dermoscopic evaluation was done to see subsurface pigment clearance. Results: In the combination group, 25% of patients had more than 50% improvement as compared with 5.71% in group 1. To achieve a mean PGA score of 1.4, it took six sessions for group 1 versus only four for group 2. Dermoscopic evaluation showed faster pigment clearance in the combination group. Conclusion: Combining two lasers shows statistically significant faster and greater degree of improvement as compared with Q-Switched Nd:YAG laser monotherapy in nevus of Ota. [ABSTRACT FROM AUTHOR]

Dermal melanocytosis is a histological term used to describe a clinical spectrum of cutaneous diseases which present as bluish-gray pigmentation of the skin. The most common forms include the Mongolian spot (MS), nevus of Ota, nevus of Ito, and dermal melanocyte hamartoma sharing similar etiologies and histologic findings but different associations and prognosis. Although these lesions usually resolve by 1 to 2 years of age, widespread aberrant MSs, nevus of Ota, and nevus of Ito can persist into adulthood and can become a great concern for the patients regarding the pigmentation and health risk associated with the same. An extensive literature search was done; all clinical trials, randomized double-blind or single-blind controlled trials, open-label studies, retrospective studies, reviews, case series, and case reports concerned with dermal melanocytosis were screened. The selected articles were retrieved; the final manuscript was prepared, analyzed, and presented in a narrative fashion. [ABSTRACT FROM AUTHOR]

A nevus is characterized by collection of partially differentiated or well-differentiated cells normally found in the skin. Some nevi are associated with disorders such as autism, epilepsy, ophthalmogical disorders, intracranial abnormalities, and others. In this case series, we aim to analyze six cases with congenital nevus, matched our findings with case reports published and reviewed the literature, to come to a conclusion that would help the clinician to do focused clinical examination and investigations when they come across such nevi. Furthermore, as these sort of skin lesions cause psychological morbidity to both parents and patients, proper counseling is required along with dermatological therapy and treatment of comorbid conditions. As well as regular follow-up with monitoring of the lesions. The following are the cases: Case-1, is a case of congenital melanocytic nevi who presented with delayed milestone, epilepsy and neuroimaging revealed intracranial melanosis. Case-2 nevus of Ota on face with scleral nevus and glaucoma in the left eye. In Case-3: Nevus achromicus was present over the abdomen and scalp in a child who presented with status epilepticus and there was focal cortical dysplasia of left frontal cortex on imaging. Nevus sebaceous was present in case-4 who had seizure disorder but neuroimaging was normal. Case-5 child had nevus spilus over left frontal area with melanocytic satellite nevi who presented with febrile convulsion but normal neuroimaging. The sixth case is a 5-year-old male child with linear nevus without any other association. [ABSTRACT FROM AUTHOR]

Dermal melanocytosis is a histological term used to describe a clinical spectrum of cutaneous diseases which present as bluish-gray pigmentation of the skin. The most common forms include the Mongolian spot (MS), nevus of Ota, nevus of Ito, and dermal melanocyte hamartoma sharing similar etiologies and histologic findings but different associations and prognosis. Although these lesions usually resolve by 1 to 2 years of age, widespread aberrant MSs, nevus of Ota, and nevus of Ito can persist into adulthood and can become a great concern for the patients regarding the pigmentation and health risk associated with the same. An extensive literature search was done; all clinical trials, randomized double-blind or single-blind controlled trials, open-label studies, retrospective studies, reviews, case series, and case reports concerned with dermal melanocytosis were screened. The selected articles were retrieved; the final manuscript was prepared, analyzed, and presented in a narrative fashion.

Nevus of Ota is a macular discoloration of the face which is most commonly found in the Japanese and females are more commonly affected than males. It is first described by Ota and Tanino in 1939, involves the skin along the distribution of first and second division of trigeminal nerve. Involvement of the palatal mucosa occurs rarely in nevus of Ota, it usually blends with the oral mucosa and is typically irregular, undefined and often present as a mottled patch. We describe here the case of nevus of Ota with palatal involvement in a 13-year-old Asiatic boy. His past medical history revealed the presence of the lesion since birth. There were no other pigmented lesion locations. The exact etiology of nevus of Ota is still unknown but they have the potential to undergo melanomatous change. [ABSTRACT FROM AUTHOR]

• The overlapping of large facial nevus spilus and nevus of Ota is exceedingly rare. • Differential diagnosis is required from isolated nevus spilus, nevus of Ota, café-au-lait macules, and partial unilateral lentiginosis. • It is recommended that clinicians utilize dermoscopy and RCM for diagnosis, monitoring malignancy, and choosing appropriate treatment strategies. We report a rare case of large facial hyperpigmentation in a 25-year-old female. Starting one month after birth, the patient developed a blue-brown patch on the right side of her face, interspersed with black macules and papules. As she aged, the lesion progressively enlarged and darkened, eventually covering the entire right side of her face. Dermoscopic and reflectance confocal microscopy examinations indicated nevus spilus in some areas and nevus of Ota in others, leading to a definitive diagnosis of overlapping nevus spilus and nevus of Ota. With no signs of malignant transformation on clinical or imaging examination, successful treatment was achieved using Q-switched alexandrite laser without any adverse effects. Our case underscores the critical value of dermoscopy and reflectance confocal microscopy in diagnosing rare facial pigmentary conditions, as we compare the imaging characteristics of nevus spilus, nevus of Ota, and similar conditions, alongside their clinical and histopathological correlations. Furthermore, our findings highlight the significant role of imaging examinations in monitoring malignancy and guiding treatment decisions. [ABSTRACT FROM AUTHOR]

Nevus of Ota and nevus of Ito are dermal melanocytoses, usually presenting themselves as a bluish-black or grayish-brown, patchy, diffuse, or mottled pigmentation of the skin. They share a common pathogenic mechanism involving failure in the migration of melanocytes from the dermis to the epidermis and differ only in the sites of their distribution on the body. Nevus of Ota, often unilateral, may rarely be bilateral or may involve the oral mucosa. Even rarer is its association with nevus of Ito and other extracutaneous features. A port-wine stain is a form of congenital capillary malformation presenting itself as a pinkish-red to purple discoloration, most commonly of the unilateral head and neck area. Only 25% of cases occur on other sites of the body. The presence of a port-wine stain in conjunction with two different dermal nevi has been an exceedingly rarely reported entity. Herein, we report a 26-year-old male who presented himself with a bilateral nevus of Ota with oral mucosal involvement and associated with nevus of Ito and a port-wine stain. [ABSTRACT FROM AUTHOR]

During the laser treatment of pigmented dermatosis such as Nevus of Ota, vapor bubbles will be generated by the laser with short pulse width and high energy density. Laser irradiation is efficacious for the clinical treatment of Ota's Nevus caused by hyperplasia of melanosomes in dermis. Since the mechanism of the laser–melanosome interaction is not yet clear, the clearance rate is generally low and bleeding of irradiated skin frequently occurs. This work conducted a flow visualization experiment to investigate the laser–melanosome interaction mechanism by using high-speed imaging. Pigmented phantom was prepared to simulate the diseased dermis tissue, where agar acted as substrate and synthetic melanin particles was infused as hyperplastic melanosomes. Putting the phantom into water, its thermo-mechanical responses to single-pulse 1064-nm Nd:YAG laser irradiation with energy density of 4–7 J/cm2 and pulse duration of 6 ns were recorded. The results indicated that laser-induced bubble formation caused by the gasification of tissue moisture is the key mechanism of laser–melanosome interaction, and an optimal energy density of 6 J/cm2 is recommended. [ABSTRACT FROM AUTHOR]

Phakomatosis Pigmento Vascularis (PPV) refers to a developmental abnormality characterized by concurrence of pigmented and capillary malformation with or without systemic manifestations. Abnormal development of melanocytic nevus cells and vasomotor neural cells arising from the neural crest has been attributed in the pathogenesis of PPV. It is classified into 5 major subtypes. Although there is no sex predilection, a preponderance of these cases has been noted in Japan. Through this rare case report, we describe the oral changes of PPV type II b in a 28 year old Indian male patient.

Objective To evaluate the efficacy of 1064nm Q-switched Nd:YAG laser in the treatment of Nevus of Ota. Methods This study was conducted in Department of Dermatology, Unit-II, KEMU/Mayo Hospital, Lahore. A total of 100 patients of nevus of Ota (both unilateral and bilateral) with Fitzpatrick skin type III to V were included in this study. Baseline photographs and Pigment area and Severity Index (PSI) score was recorded. All patients were treated with 1064nm Q-switched Nd:YAG laser at fluence of 500-600 V and frequency of 5Hz. A total of 10 sessions at 2 weeks interval were given. Final assessment was done at 4 weeks after last session. Improvement was measured in terms of percentage reduction in baseline PSI score. Results Mean age of the patients was 24.35±5.70 years. There were 15.0% males and 85.0% females. Majority of the patients had duration of lesion > 15 years. Most of the patients presented with skin type IV. 52.0% patients showed more than 50% clinical improvement. Improvement was higher in females (56%) and in patients with skin type III (50%) and IV (60%). Stratification with regards to age and duration of lesion showed no statistically significant difference. Conclusion Fifty two % of patients of nevus of Ota treated with 1064 nm Q-switched Nd:YAG laser showed more than 50% improvement. [ABSTRACT FROM AUTHOR]

Purpose: to report the utility of Anterior Segment Optical Coherence Tomography (AS OCT) for planning superficial sclerectomy in a patient with nevus of Ota. Observations: Oculodermal melanocytosis, also called nevus of Ota, is a benign pigmentary disorder that involves the skin innervated by the first and second branches of the trigeminal nerve. To reduce these black or brownish lesions, different surgical treatments have been reported, such as flipped scleral flap, sclera allograft and the grabbing method. Superficial sclerectomy is a recent technique that has proven effective in improving scleral pigmentation. Although this procedure allows the operating time to be reduced and results in a smoother scleral bed surface, it has a limitation, represented by the difficulty of estimating the depth of the sclerectomy: an inaccurate estimate or incorrect depth could cause an inadequate deep scleral dissection with excessive weakening of the sclera. We report a case of a 27-year-old patient with nevus of Ota undergoing superficial sclerectomy. The depth of scleral pigmentation was evaluated with AS OCT images before the surgery, allowing a superficial sclerectomy to be performed with a precalibrated diamond blade. Conclusions and Importance: In oculodermal melanocytosis (nevus of Ota) the use of AS OCT images showing the depth of scleral pigmentation could lead to the most effective and safest surgical choice for each case.

Nevus of Ota (NOO) is a dermal melanocytoses characterized by bluish-brown macules along the distribution of trigeminal nerve. Ocular involvement is observed in most of the patients in the form of scleral pigmentation. Also reported associations in this condition are iris/ciliary body pigmentation/glaucoma, ocular melanoma, etc. Hence, the terms nevus fusco-ceruleus ophthalmo-maxillaris and oculodermal melanocytosis are used to refer to this condition. Bilateral NOO is a rarely encountered condition, with only few scattered case reports in the literature. In this study, we report a rare presentation of bilateral NOO in four patients. The condition is important to recognize due to cosmetic concern it poses and limited treatment options.

Objective To determine the efficacy and safety of Q-Switched Nd-YAG laser in the treatment of various pigmentary cutaneous disorders. Methods This study was carried out at Department of Dermatology Shaheed Mohtarma Benazir Bhutto Skin Complex Larkana from May 2017 to November 2017. A total of 40 patients, who fulfilled the inclusion criteria (who failed the conventional treatment) were enrolled for this study after taking informed consent. The diagnosis of all cases was made on clinical basis. Spot sizes vary from 3cm to 20cm were treated with Q-switched laser on weekly basis. The result of pigmentation was assessed initially after 3 sessions followed by every week session with grading and photographs. Adverse effects were recorded after each visit. Results A total of 40 cases participated, 27 (67.5%) out of 40 were of melasma, 11 (27.5%) were of Nevus of ota and 2 (5%) were of Tattoo Marks. Out of 27 (67.5%) cases of melasma 5 (18.5%) showed minimum hyper pigmentation as before treatment with Nd YAG Laser were graded as severe hyper pigmentation, 7 (27.9%) showed moderate hyper pigmentation and 15 (55.5%) cases didn't gave any response and discontinued the treatment. Out of 11 (27.5%) cases of Nevus of ota 8 (27.7%) showed marked improvement and 3 (27.2%) showed moderate improvement. The 2 cases of Tattoo Marks gave good response and were males. The treatment response was statistically significant (p=0.92) and was statistically no significant gender difference (p=.819). Conclusion we conclude that Q-Switched Nd YAG laser is good modality to treat various pigmentory skin disorders in which conventional treatment is less satisfactory. [ABSTRACT FROM AUTHOR]

Phakomatosis pigmentovascularis (PPV) is a rare congenital condition characterized by a combination of cutaneous capillary hemangiomas and dermal melanocytosis. The dual presentation of Sturge–Weber syndrome (SWS) and nevus of Ota in the same patient is a rare finding. Individually, both these conditions can predispose to developmental glaucoma. The combined presentation of these two predisposing conditions has a very high chance of coexisting glaucoma. We report a patient of PPV presenting with bilateral SWS, nevus of Ota, and congenital glaucoma.

Background Nevus of Ota is a dermal hamartoma that presents as bluish/slate gray pigmentation along first or second branch of trigeminal nerve. Patients search for treatment early in life due to psychological trauma and cosmetic disfigurement. The establishment of high power, short pulse Q switched (QS) lasers has provided a tool for substantial therapeutic advances in the management of dermal pigmented lesions. Objectives The aim of the present study was to correlate the clinical efficacy of QS Nd : YAG laser with histological, as well as histometric findings through studying the quantitative changes of dermal melanocyte surface area in nevus of Ota patients after treatment. Patients and methods Twelve patients with nevus of Ota were subjected to multiple treatment sessions with 1064 nm QS Nd : YAG laser at 2 months interval accomplished over a period of 2 years. Skin types treated included phototypes III and IV. All patients were photographed before, after each session and at the end of treatment. Skin biopsies were taken from all patients before treatment and after six sessions to perform histological and histometric analysis. Results Excellent improvement was noticed in four (33.3%) patients, good improvement in five (41.6%) patients, and one (8.3%) patient showed fair response. While, poor response was seen only in two (16.7%) patients. Hematoxylin and eosin and Fontana-Masson stained sections showed significant decrease in the number of elongated spindle-shaped dermal melanocytes throughout the dermis. Meanwhile, histometric study revealed significantly decreased dermal melanocyte surface area after treatment. Conclusion QS Nd : YAG laser is an effective and easy-to-perform treatment in cases of nevus of Ota in Egyptian patients with minimal side effects. Histological and histometric findings correlated with the clinical improvement attained.

Introduction: Phakomatosis pigmentovascularis (PPV) is a rare congenital syndrome characterized by the simultaneous presence of capillary malformation and pigmentary nevi. The objective of our study was to describe the clinical characteristics of a series of Indian patients presenting with this rare entity. Materials and Methods: It was a record-based descriptive case series. Results: A total of 11 patients with PPV (9 females, 2 males, age range: 7 days to 45 years; mean 11.6 years) were studied. Port wine stain was present in 10 (91%) patients and one patient (9%) had cutis marmorata telangiectatica congenita. Isolated nevi of Ota and Mongolian spots were seen in 4 (36%) patients each. Simultaneous presence of both Mongolian spots and nevus of Ota was present in 1 (9%) patient. The combination of Mongolian spots and bilateral palatal hyper-melanosis was noticed in 2 (18%) patients. Café au lait macule was present in one patient. Bilateral ocular melanosis was found in 3 (27%) patients. Unilateral ocular melanosis was noticed in 4 (36%) patients. Two patients (18%) had history of seizure disorder and intracranial vascular anomalies on MRI imaging. Two patients (18%) had features of Klippel-Trenaunay syndrome. According to the traditional classification, three patients had PPV type 2b, one patient had PPV type 5b, and seven patients had PPV type 2a. According to the Happle's classification, 10 patients had PPV of cesio flammea type, and one patient had PPV of cesio marmorata type. Limitations: We could not perform genetic study of the patients. Conclusion: Our findings emphasize the importance of detailed systemic evaluation including ocular examination and brain imaging in every patient of PPV.

During the laser treatment of pigmented dermatosis such as Nevus of Ota, vapor bubbles will be generated by the laser with short pulse width and high energy density. Laser irradiation is efficacious for the clinical treatment of Ota’s Nevus caused by hyperplasia of melanosomes in dermis. Since the mechanism of the laser–melanosome interaction is not yet clear, the clearance rate is generally low and bleeding of irradiated skin frequently occurs. This work conducted a flow visualization experiment to investigate the laser–melanosome interaction mechanism by using high-speed imaging. Pigmented phantom was prepared to simulate the diseased dermis tissue, where agar acted as substrate and synthetic melanin particles was infused as hyperplastic melanosomes. Putting the phantom into water, its thermo-mechanical responses to single-pulse 1064-nm Nd:YAG laser irradiation with energy density of 4–7 J/cm2 and pulse duration of 6 ns were recorded. The results indicated that laser-induced bubble formation caused by the gasification of tissue moisture is the key mechanism of laser–melanosome interaction, and an optimal energy density of 6 J/cm2 is recommended.

Competing Interests: None disclosed.

Background Acquired bilateral nevus of Ota-like macules (ABNOM) are a common form of hyperpigmentation in Asian populations, characterized by brownish-blue or slate-gray pigmentation in the bilateral malar regions. The purpose of this study was to evaluate the efficacy and complications of a Q-switched (QS) fractional ruby laser in the treatment of ABNOM. Methods Forty-four patients with ABNOM treated with a QS fractional ruby laser from January 2014 to February 2016 were enrolled in this study. Patients received up to 10 treatment sessions, at intervals ranging from 3 to 4 weeks. An automatic skin diagnosis system was used before and after laser treatment to evaluate the efficacy of the laser treatment. To evaluate the complications of the laser treatment, a retrospective chart review was conducted. Results Forty-one patients were female, and 3 were male. The mean age of the patients was 47.2 years, and the mean follow-up period was 14 months. The median skin pigmentation score was 5 (interquartile range [IQR], 5–6) before laser treatment and 3 (IQR, 3–4) after laser treatment. A statistically significant difference (P < 0.01) was found in the skin pigmentation score before and after laser treatment. Conclusions This study suggests that, although multiple sessions are required, QS ruby fractional lasers can be considered an effective and less invasive form of treatment of ABNOM.

Nevus of Ota (NOO) is a dermal melanocytoses characterized by bluish-brown macules along the distribution of trigeminal nerve. Ocular involvement is observed in most of the patients in the form of scleral pigmentation. Also reported associations in this condition are iris/ciliary body pigmentation/glaucoma, ocular melanoma, etc. Hence, the terms nevus fusco-ceruleus ophthalmo-maxillaris and oculodermal melanocytosis are used to refer to this condition. Bilateral NOO is a rarely encountered condition, with only few scattered case reports in the literature. In this study, we report a rare presentation of bilateral NOO in four patients. The condition is important to recognize due to cosmetic concern it poses and limited treatment options. [ABSTRACT FROM AUTHOR]

Q-switched neodymium-yttrium aluminum-garnet (Q-switched Nd:YAG) laser has been reported as an effective treatment for nevus of Ota and acquired bilateral nevus of Ota-like macules (ABNOM). Data on ectopic Mongolian spots have rarely been reported.The present study was performed to investigate the treatment efficacy of a high-fluence 1064 nm Q-switched Nd:YAG laser without tissue whitening in ectopic Mongolian spots.We included 61 patients with ectopic Mongolian spots, and 70 lesions were examined. Thirty-three lesions were treated with a high-fluence 1064 nm Q-switched Nd:YAG laser, and 38 lesions were observed without treatment. The results were assessed using a 5-quantile grading scale and melanin index using a Mexameter®.Mean follow-up duration was 14.1 ± 6.8 months for the treatment group and 17.8 ± 10.0 months for the observation group. Mean 5-quintile grading scale at final follow-up was statistically different ( p  < 0.001) between the two groups (treatment: 2.85 ± 1.00, observation: 0.49 ± 0.73). There was a significant difference ( p  < 0.001) in the Δ melanin index (initial melanin index - final melanin index) between the observation (7.1 ± 62.7) and treatment (156.7 ± 78.4) groups.High-fluence Q-switched Nd:YAG laser without tissue whitening showed good results and was well-tolerated in treating ectopic Mongolian spots.

Introduction: Phakomatosis pigmentovascularis (PPV) is a rare congenital syndrome characterized by the simultaneous presence of capillary malformation and pigmentary nevi. The objective of our study was to describe the clinical characteristics of a series of Indian patients presenting with this rare entity. Materials and Methods: It was a record-based descriptive case series. Results: A total of 11 patients with PPV (9 females, 2 males, age range: 7 days to 45 years; mean 11.6 years) were studied. Port wine stain was present in 10 (91%) patients and one patient (9%) had cutis marmorata telangiectatica congenita. Isolated nevi of Ota and Mongolian spots were seen in 4 (36%) patients each. Simultaneous presence of both Mongolian spots and nevus of Ota was present in 1 (9%) patient. The combination of Mongolian spots and bilateral palatal hyper-melanosis was noticed in 2 (18%) patients. Café au lait macule was present in one patient. Bilateral ocular melanosis was found in 3 (27%) patients. Unilateral ocular melanosis was noticed in 4 (36%) patients. Two patients (18%) had history of seizure disorder and intracranial vascular anomalies on MRI imaging. Two patients (18%) had features of Klippel-Trenaunay syndrome. According to the traditional classification, three patients had PPV type 2b, one patient had PPV type 5b, and seven patients had PPV type 2a. According to the Happle's classification, 10 patients had PPV of cesio flammea type, and one patient had PPV of cesio marmorata type. Limitations: We could not perform genetic study of the patients. Conclusion: Our findings emphasize the importance of detailed systemic evaluation including ocular examination and brain imaging in every patient of PPV. [ABSTRACT FROM AUTHOR]

This report describes the clinical presentation, diagnosis, and histopathologic features of oculodermal melanocytosis in a young dog. A 3-year-old male neutered Labrador Retriever presented with conjunctival and scleral hyperpigmentation of the right eye, with concurrent ipsilateral cutaneous hyperpigmentation involving the right side of the face. Initial skin and conjunctival biopsies revealed an accumulation of histologically benign melanocytes within the dermis and conjunctival stroma, respectively. Enucleation was elected 19 months later by the referring veterinarian due to the progression of ocular pigmentation with concurrent marked corneal lipidosis and the suspicion of a scleral mass. On gross and histopathologic examination of the globe, there was marked panuveal melanocytosis with extension into the sclera, bulbar conjunctiva, and connective tissue surrounding the optic nerve, as well as sharply demarcated ipsilateral hyperpigmentation of the facial skin. The findings are characteristic of oculodermal melanocytosis (nevus of Ota), a dermal melanocytic hamartoma presenting as cutaneous facial hyperpigmentation that corresponds to the distribution of the ophthalmic and maxillary branches of the trigeminal nerve, often with ipsilateral ocular involvement. [ABSTRACT FROM AUTHOR]

The Sturge-Weber syndrome consists of unilateral port wine hemangioma of skin along the trigeminal distribution associated with an ipsilateral leptomeningeal angioma. Nevus of Ota (oculodermal melanosis) is a hamartoma of dermal melanocytes which presents as a blue or gray patch on the face and conjunctiva, which is congenital or acquired and is within the distribution of the branches of the trigeminal nerve. The coexistence of cutaneous hemangioma and pigmentary naevi is known as phakomatosis pigmentovascularis. We report the first case of phakomatosis pigmentovascularis in the Indian literature.

Cryogen spray cooling (CSC) could be applied clinically for the laser therapy of Ota’s nevus, a dermal hyperplastic pigmented disease with a morbidity rate of 0.1–0.6% in the Asian population. An accurate, efficient, complete simulation system that considers the entire spray cooling process, including cryogen flow in the tube nozzle, spray dynamics and internal phase change heat transfer (cold injury) in skin tissue, was established to determine suitable cryogen and cooling parameters. The optimum spray distances for R134a, R404A and R32 were determined to be 66.0, 43.1 and 22.5 mm, respectively. The corresponding maximum surface heat fluxes were 363.5, 459.9, and 603.6 kW∙m−2, respectively. The maximum surface heat flux of R32 with small spray distance was 1.66 times as large as that of R134a, indicating the potentially good cooling performance and precise targeted cooling of R32 during the laser therapy of Ota’s nevus. The cooling durations that caused cold injury of skin tissue were 2.3, 1.4, and 1.1 s for R134a, R404A, and R32, respectively. The interval between CSC and laser irradiation was optimized to 90–162 ms for R134a, R404A and R32, in consideration of the cooling effect, depth, uniformity, and risk of cold injury.

Objective To determine the demographic, epidemiological and clinical features and associations of different types of nevi from eastern India. Methods This descriptive study was carried out R. G. Kar Medical College and Hospital, Kolkata over 12 months (from March 2013 to February 2014). Two hundred patients of all age groups and both sexes presenting with or found to have nevi were evaluated for demographical, clinical variables and comorbidities. Results The most common type of nevus in our study was Becker's nevi and the least common was eccrine angiomatous nevus. Most common age of presentation was the first and second decades. An overall female preponderance was noted in our study. Infantile hemangioma was seen more commonly in girl children. Nevus of Ota was commoner in females. In contrast to previous findings, majority of VEN lesions were on head and neck region, followed by trunk. Most of the lesions of ILVEN affected lower half of the body. Conclusion A diverse variety of nevi were seen, more commonly in females. They usually appear in the first and second decade of life. Patients should be meticulously examined for cutaneous and systemic associations. [ABSTRACT FROM AUTHOR]

Abstract Phacomatosis pigmentovascularis is a rare syndrome, defined as the simultaneous presence of vascular nevus and melanocytic nevus in the same patient. We report the case of a 53-year-old woman presented with dermal melanosis and extensive vascular nevus, which match the typical manifestations of phakomatosis pigmetovascularis of cesioflammea type, according to Happle's classification. The rare occurrence of this genodermatosis and the clinical exuberance of the skin lesions motivated this case report.

Phacomatosis Pigmentovascularis is a rare syndrome characterized by capillary malformation and pigmentary nevus. A case of a 2-year-old patient is reported, who presented extensive nevus flammeus and an aberrant Mongolian spot, without systemic disease, manifestations that allow us to classify this case as type IIa Phacomatosis Pigmentovascularis, according to Hasegawa's classification.