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Comparing the efficacy and safety of Q-switched and picosecond lasers in the treatment of nevus of Ota: a systematic review and meta-analysis

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Abstract

Nevus of Ota is cosmetically burdensome and often prompts patients to seek treatment. Lasers are commonly used in removing these lesions; however, no systemic analysis has been conducted to support a gold standard laser. To conduct a meta-analysis of the efficacy and safety of Q-switched Nd:YAG lasers (QSNL), Q-switched ruby lasers (QSRL), Q-switched alexandrite lasers (QSAL), and picosecond alexandrite lasers (PSAL) in removing nevus of Ota. Inclusion criteria were nevus of Ota patients treated with QSNL, QSRL, QSAL, or PSAL and documentation of percent clearance and the rate of at least one adverse event. Articles in English, Chinese, or Japanese were included. The prespecified outcome measures were efficacy (percent clearance) and safety (rates of hyperpigmentation, hypopigmentation, scarring, and recurrence). The review included 57 studies and 13,417 patients. The pooled success rate was 64% for QSNL (95% CI 52–76%), 54% for QSRL (95% CI 39–69%), 58% for QSAL (95% CI 44–72%), and 100% for PSAL (95% CI 98–102%). The pooled adverse event rate was 5% for QSNL (95% CI 4–6%), 14% for QSRL (95% CI 9–19%), 9% for QSAL (95% CI 6–12%), and 44% (95% CI 31–57%) for PSAL. QSNL has the most evidence for effectively and safely treating nevus of Ota. PSAL potentially has a superior efficacy; however, further studies are needed to elucidate its side effect profile when treating nevus of Ota.

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Acknowledgments

We would like to acknowledge the hardworking interlibrary loan staff at the University of Miami Calder Memorial Library and Otto G. Richter Library who assisted in retrieving the full-text articles for this study. We would also like to thank Rachel Couban, MA, MISt, from the DeGroote Institute for Pain Research and Care at McMaster University, Hamilton, ON, for peer review of the Medline search strategy.

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  1. Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1150 NW 14th Street, Miami, FL, 33136, USA

    Natalie M. Williams, Pooja Gurnani, Jun Long, Takahiro Suzuki, Ghadah I. Alhetheli & Keyvan Nouri

  2. University of Miami Miller School of Medicine, Miami, FL, USA

    John Reynolds

  3. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA

    Yue Pan

  4. Department of Dermatology and Cutaneous Surgery, College of Medicine, Qassim University, Buraydah, Saudi Arabia

    Ghadah I. Alhetheli

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• NW: project design, title/abstract screening, full-text screening, quality appraisal, data extraction, wrote manuscript

• PG: title/abstract screening, English full-text screening, quality appraisal, data extraction, edited manuscript

• JL: title/abstract screening, Chinese full-text screening, quality appraisal, data extraction

• JR: creation of search strategy, completion of in-depth literature search

• TS: title/abstract screening, Japanese full-text screening, quality appraisal, data extraction

• YP: statistical analysis, edited manuscript

• GA: third person for title/abstract and full-text screening to resolve conflicts

• KN: project design, edited manuscript

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Correspondence to Natalie M. Williams.

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Williams, N.M., Gurnani, P., Long, J. et al. Comparing the efficacy and safety of Q-switched and picosecond lasers in the treatment of nevus of Ota: a systematic review and meta-analysis. Lasers Med Sci 36, 723–733 (2021). https://doi.org/10.1007/s10103-020-03125-9

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