Ann Dermatol.  2017 Aug;29(4):446-453. 10.5021/ad.2017.29.4.446.

Treatment and Classification of Nevus of Ota: A Seven-Year Review of a Single Institution's Experience

• Nam JH
• Kim HS
• Choi YJ
• Jung HJ
• Kim WS

• KMID: 2388943
• DOI: http://doi.org/10.5021/ad.2017.29.4.446

Abstract

BACKGROUND
Nevus of Ota (NO) is a relatively common pigmentary disorder in Asians. Tanino's classification is an old but tacit consensus to delineate the disease. Various treatment options have been presented. However, a few studies have been conducted on available laser options and current treatment strategies or the classification of NO.
OBJECTIVE
To investigate current laser options and their effectiveness for the treatment of NO, contributing factors to clinical outcomes, and verification of classification.
METHODS
A retrospective study of NO was conducted by reviewing medical charts and photographs of sixty-seven patients. Statistical analysis was used to compare excellent and poor outcomes and determine contributing factors.
RESULTS
The median age of onset was below the age of 1 (interquartile range [IQR], 0~1). Tanino's and PUMCH classification systems failed to classify patients in 24 (35.8%) and 6 (9.0%) of patients, respectively. A 1,064 nm Q-switched Nd:YAG laser without additional lasers was used most frequently in 42 patients (62.7%). The frequency of treatment was 19.0 (IQR, 10.0~23.0) in the cured group defined as subjects showing 95% improvement or above, compared to 10.0 (IQR, 6.25~13.75) in the unattained group defined as subjects showing less than 95% improvement (p=0.001).
CONCLUSION
A 1,064 nm Q-switched Nd:YAG laser is a reliable treatment armamentarium, functioning as a single infallible modality as well as a combination treatment modality for NO. Repetitive laser treatments without interruption seems to be the most suitable in clearing NO. The current classification systems of NO are defective. Thus, a new classification should be developed.

Keyword

Classification; Nevus of Ota; Laser therapy; Pigmentation

MeSH Terms

Age of Onset
Asian Continental Ancestry Group
Classification*
Consensus
Humans
Laser Therapy
Nevus of Ota*
Nevus*
Pigmentation
Retrospective Studies

Figure

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  Fig. 1 Representative photos on three-point severity scale: (A) mild, (B) moderate, and (C) severe.

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  Fig. 2 Clinical images of (A) a 14-month-old male patient and (B) a 12-year-old female patient not specified with Tanino's classification, but specified with the Peking Union Medical College Hospital (PUMCH) classification type IIb and type Ib2, respectively.

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  Fig. 3 Clinical images of (A) a 14-month-old male patient and (B) a 6-year-old female patient not specified with both Tanino's and the Peking Union Medical College Hospital (PUMCH) classification.

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  Fig. 4 Common laser combinations in proportion. 1,064 QSNY: 1,064 nm Q-switched neodymium-doped yttrium aluminium garnet (Nd:YAG) laser, 1,064 PTP: 1,064 nm photoacoustic twin pulse mode Nd:YAG laser, 1,064 Pico: 1,064 nm picoseconddomain Nd:YAG laser.

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  Fig. 5 A 5-year-old male patient classified as “mild” (A) before treatment, and (B) at the final visit after 26 treatments (excellent outcome).

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  Fig. 6 A 3-year-old female patient classified as “moderate” (A) before treatment, and (B) at the final visit after 30 treatments (excellent outcome).

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  Fig. 7 A 40-year-old male patient classified as “severe” (A) before treatment, and (B) at the final visit after 14 treatments (excellent outcome).

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