Efficacy of Long-Pulsed Nd:YAG Laser for Classic Kaposi’s Sarcoma: A Dermoscopic Study
Keywords:
Classic Kaposi’s Sarcoma, dermatoscopy, Long-Pulse Neodymium-Doped Yttrium–Aluminum–Garnet Laser, treatmentAbstract
Introduction: Classic Kaposi’s sarcoma (CKS) is a chronic and indolent skin tumor. Because CKS has a low mortality rate but can have a significant impact on quality of life, it is important to choose safe, long-term treatments with minimal side effects.
Objectives: The aim was to assess the efficacy of long-pulsed Nd:YAG laser therapy in treating CKS based on clinical and dermoscopic observations.
Methods: Forty-two nodular lesions from three CKS patients (stage 4) were treated using a long-pulsed Nd:YAG laser with a spot size ranging from 3 to 7 mm, a fluence of 200–250 j/cm2, and a pulse duration lasting between 10 and 20 milliseconds in one or two sessions. Patients were photographed clinically and dermoscopically before the procedure, immediately after the procedure, and at 1, 6, and 12 months after the procedure.
Results: All participants displayed significant clinical and dermoscopic improvements, and all lesions healed within 2–3 weeks, resulting in only minor atrophic scars. No instance of recurrence was found among any of the patients during the 1-year follow-up.
Conclusions: Nd:YAG laser therapy may prove to be an effective therapeutic alternative for both early and advanced-stage CKS, specifically in instances of stubborn cutaneous lesions or patients receiving systemic therapy. The treatment results in quick improvement, typically within 2–3 weeks, and is well tolerated. Nd:YAG laser therapy could provide potential benefits for HIV-positive patients as it is free from immunosuppression, easy to apply to recurring lesions, and demonstrates overall effectiveness and safety.
References
Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. Mar 1 2015;136(5):E359-86. doi:10.1002/ijc.29210
Lebbe C, Garbe C, Stratigos AJ, et al. Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC). Eur J Cancer. Jun 2019;114:117-127. doi:10.1016/j.ejca.2018.12.036
Brambilla L, Genovese G, Berti E, et al. Diagnosis and treatment of classic and iatrogenic Kaposi's sarcoma: Italian recommendations. Ital J Dermatol Venerol. Jun 2021;156(3):356-365. doi:10.23736/s2784-8671.20.06703-6
Régnier-Rosencher E, Guillot B, Dupin N. Treatments for classic Kaposi sarcoma: a systematic review of the literature. J Am Acad Dermatol. Feb 2013;68(2):313-31. doi:10.1016/j.jaad.2012.04.018
Ertürk Yılmaz T, Akay BN, Okçu Heper A. Dermoscopic findings of Kaposi sarcoma and dermatopathological correlations. Australas J Dermatol. Feb 2020;61(1):e46-e53. doi:10.1111/ajd.13150
Dupin N. Update on oncogenesis and therapy for Kaposi sarcoma. Curr Opin Oncol. Mar 2020;32(2):122-128. doi:10.1097/cco.0000000000000601
Iftode N, Rădulescu MA, Aramă Ș S, Aramă V. Update on Kaposi sarcoma-associated herpesvirus (KSHV or HHV8) - review. Rom J Intern Med. Dec 1 2020;58(4):199-208. doi:10.2478/rjim-2020-0017
Brambilla L, Mattioli MA, Tourlaki A. Multiple Kaposi's sarcoma nodules successfully treated by curettage and vincristine injections in the same session. Australas J Dermatol. Aug 2023;64(3):443-445. doi:10.1111/ajd.14075
Özdemir M, Balevi A. Successful Treatment of Classic Kaposi Sarcoma With Long-Pulse Neodymium-Doped Yttrium Aluminum Garnet Laser: A Preliminary Study. Dermatol Surg. Mar 2017;43(3):366-370. doi:10.1097/dss.0000000000000973
Silvestri M, Latini A, Lesnoni La Parola I, Messina C, Nisticò SP, Cameli N. Effectiveness and Safety of Treatment with Neodymium:YAG Laser 1064 nm in Patients with Classic and Epidemic Kaposi Sarcoma. Bioengineering (Basel). Mar 5 2022;9(3)doi:10.3390/bioengineering9030106
Landthaler M, Hohenleutner U. Laser therapy of vascular lesions. Photodermatol Photoimmunol Photomed. Dec 2006;22(6):324-32. doi:10.1111/j.1600-0781.2006.00254.x
Nasca MR, Luppino I, Spurio Catena A, Micali G. Nodular Classic Kaposi's Sarcoma Treated With Neodymium-Doped Yttrium Aluminum Garnet Laser Delivered Through a Tilted Angle: Outcome and 12-Month Follow Up. Lasers Surg Med. Dec 2020;52(10):979-983. doi:10.1002/lsm.23242
Nasca MR, Luppino I, Micali G. Kaposi's Sarcoma-Related Lymphedema Treated by a Nd:YAG Laser. Dermatol Surg. Aug 1 2021;47(8):1139-1140. doi:10.1097/dss.0000000000002904
Martinez V, Caumes E, Gambotti L, et al. Remission from Kaposi's sarcoma on HAART is associated with suppression of HIV replication and is independent of protease inhibitor therapy. Br J Cancer. Apr 10 2006;94(7):1000-6. doi:10.1038/sj.bjc.6603056
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