Recurrence rate of oral melanotic macule treated with Q-switched alexandrite laser versus surgical excision: a retrospective cohort study

• Main Authors: SUN Kai, SHI Linjun, SHEN Xuemin
• Format: Article in Journal/Newspaper
• Language: Chinese
• Published: Editorial Department of Journal of Prevention and Treatment for Stomatological Diseases 1481
• Subjects: oral melanotic macule; q-switched alexandrite laser; surgical excision; follow-up; recurrence; adverse reaction; depression; scar; Medicine; R; Meier; SCAR
• Online Access: https://doi.org/10.12016/j.issn.2096⁃1456.2024.01.006; https://doaj.org/article/9493fbdc504d4ca2b6357945935dd124

Objective To compare the recurrence rates between 755 nm Q-switched alexandrite laser (QSAL) treatment and surgical excision of oral melanotic macules (OMM). Methods This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. A retrospective cohort study was designed to collect demographic and clinical characteristics and follow-up data from patients with OMM. Patients who received QSAL or surgical excision in the Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2019 to August 2021 were included. The one-year recurrence rate was investigated as the primary outcome. Long-term adverse reaction rates were investigated as safety indicators. Kaplan-Meier analyses were performed to analyze the recurrence-free rates between the groups. Results A total of 57 patients were enrolled in this study. 16 patients underwent surgical excision, and 41 underwent QSAL. The baseline demographic and clinical characteristics between the groups were not significantly different. No recurrence (0%) of OMM was observed in the surgical excision group, while in the QSAL group, the macule recurred in 12 patients (29.27%). The average duration of recurrence was 6.08 months after treatment. Recurrence was not found to be associated with smoking (P = 1.000), gastrointestinal polyps (P = 1.000), longitudinal melanonychia (P = 0.187), family history (P = 0.552), treatment sessions (P = 0.567) or multiple macule lesions (P = 0.497). Compared with treatment with surgical excision, the odds ratio of recurrence for treatment with QSAL was 4.41, with a 95% confidence interval of 1.27-15.24 (P = 0.020). In the surgical excision group, 3 patients (18.75%) reported depressions and scars on the lesion, while no long-term adverse reactions (0%) were reported in the QSAL group (P = 0.019). Conclusion Compared with surgical excision, the advantage of QSAL is the low long-term adverse reaction rate, while the disadvantage is the ...