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Fibrous dysplasia is an uncommon bone disorder in which normal mineralized bone is replaced by proliferating fibrous tissue and immature woven bond. This may result in expansion, distortion and structural weakness of the involved bony skeleton. Fibrous dysplasia can effect a single bone in its monostotic form or multiple bones can be involved (polyostotic form). The etiology of fibrous dysplasia is unknown. The disease usually presents in childhood or early adolescence and may show continued progression into adulthood. Progression of fibrous dysplasia has also been linked to hormonal changes, particularly those of pregnancy. Malignant transformation is rare. Appropriate treatment may involve observation, conservative surgery, or radical excision with reconstruction. Indications for surgical treatment include functional deficits or significant cosmetic deformity. The aim of treatment is to restore function and cosmetic symmetry.

Lentigo maligna is a premalignant lesion of atypical melanocytes that typically arises on the head and neck of elderly patients. It is considered a melanoma in situ with a significant risk for transformation to invasive lentigo maligna melanoma. Surgery is the preferred method of treatment; however, because of the advanced age of the typical patient with lentigo maligna, the frequency of complicating medical problems, and the cosmetic or functional aspects of treatment, surgical excision is not always feasible. The purpose of this pilot study was to evaluate the efficacy and safety of Q-switched neodymium:yttrium-aluminum-garnet laser treatment of lentigo maligna. Eight patients were treated with 532 and/or 1064 nm wavelengths from the laser. All patients showed a response to laser therapy, and 2 patients treated with 1 treatment from each wavelength had complete eradication of the LM, with no evidence of recurrence in 42 months. Further study is warranted, but Q-switched neodymium:yttrium-aluminum-garnet laser is a promising alternative treatment for lentigo maligna. (Otolaryngol Head Neck Surg 1999;120:296-302.)