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Q-switched ruby laser (QSRL) and Q-switched Nd-YAG laser (QSNYL) treatment of dermal melanocytosis, especially nevus of Ota, has produced favorable results that are mediated by selective photothermolysis. However, the precise effects of irradiation on melanosomes and cells containing melanosomes remain unclear, and an optimal method of irradiation has not been found. In this study synthetic melanin powder and pigmented dermal tissue obtained from five blue nevus lesions, also classified as dermal melanocytosis, were used as targets to identify the specific effects of these forms of irradiation in vitro. Morphological changes were assessed by microscopy after irradiation with QSRL and QSNYL at a fluence of 5 J/cm2, the fluence ordinarily utilized in clinical applications. Light microscopy revealed that most of the synthetic melanin powder retained in 1% agar was no longer visible after QSRL irradiation. In contrast, melanin powder particles were partly crushed by QSNYL irradiation. Electron microscopic examination of melanosomes in the blue nevus tissue after irradiation showed expansion and various other forms of disruption. Statistical analysis by 2-way analysis of variance (ANOVA) of the length of the major axis of the melanosomes indicated that QSRL irradiation caused significantly greater melanosome expansion than QSNYL irradiation. These findings indicate that QSRL irradiation had a greater photothermal effect on dermal melanosomes than QSNYL irradiation. This suggests that QSRL is more efficacious in the treatment of dermal melanocytosis than QSNYL.

Evaluation of the Effect of Q-Switched Ruby and Q-Switched Nd-YAG Laser Irradiation on Melanosomes in Dermal Melanocytosis.