Electrosurgery in dermatosis papulosa nigra: An effective, well-tolerated but less documented tool

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Surajit Gorai, Joly Seth, Ayush Bindal, Asit Baran Samanta, Subhas Nag, Bani Kumar Mondal

Abstract


Dermatosis papulosa nigra (DPN) is a superficial, black or brown benign papule that develops mainly in dark-skinned individuals over the face and neck. Clinically seborrheic keratosis shows a stuck-on appearance that differentiates it from DPN. Histopathological examination described that both were identical. Many types of lasers are used as treatments for it. Traditional surgical procedures such as curettage, electrosurgery, and snip/shave excision are still considered as a therapeutic modality. Although electrodessication (ED) is a simple procedure, studies on ED use for DPN with a good number of cases are lacking. This paper presents the evaluation safety, efficacy and cost-effectiveness of ED for the treatment of DPN in Fitzpatrick’s skin type IV to VI. A total of 40 patients (11 male and 29 female) with DPN over the face and neck with skin type IV–VI were included. Superficial ED (monopolar, low, 2–3.5 W) was done by just touching the lesion under topical anesthesia. All preoperative photographs as well as 2-, 4- and 8-week post-procedure photographs were examined by two independent dermatologists who had no prior information concerning the procedure, (both known hereafter as “blinded observer”): one for examining efficacy in terms of poor improvement (0%–25%), fair (26%–50%), good (51%–75%), or excellent (76%–100%), by counting completely cleared lesions; and the other for examining side effects in terms of hypo/hyperpigmentation and scarring. As a result, 85% of patients showed excellent improvement (>75% clearance), 7.5% good (51%–75% clearance), 5% fair (26%–50% clearance) and 2% poor (0–25% clearance) as measured by the “blinded” observer. Post-inflammatory hyperpigmentation was observed in 15% cases, whereas hypo-pigmentation was documented in 7.5% cases. Only in two cases (5%) was lesional scarring noted. Those complications were cleared after eight weeks. In this study, ED was observed to be an effective, well-tolerated and cost-effective method for treatment of DPN in colored skin. Complications were few, and therapy was performed appropriately with effective postoperative measures.


Keywords


Dermatosis papulosa nigra (DPN); electrodesiccation; colored skin

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References


James W, Berger T, Elston Drik, Epidermal nevi, neoplasms, and cysts. In: James W, Berger T, Elston Drik, editors. Andrews’s Diseases of the Skin: Clinical Dermatology. 11th Ed. Philadelphia: Eleventh International edition. 2011. p. 626.

Pierson D, Bandel C, Ehrig T, et al. Benign epidermal tumors and proliferations. In: Bolognia J, Jorizzo J, Rapini R, editors. Dermatology. 2nd ed. New York: Mosby; 2003. p. 1717.

Schweiger ES, Kwasniak L, Aires DJ. Treatment of dermatosis papulosa nigra with a 1,064 nm Nd: YAG laser: report of two cases. J Cosmet Laser Ther 2008;10:120–2

Sebben JE. The hazards of electrosurgery. J Am Acad Dermatol 1987;16:869-72.

Kundu RV, Joshi SS, Suh KY, et al. Comparison of electrodesiccation and potassium-titanyl-phosphate laser for treatment of dermatosis papulosa nigra. Dermatol Surg 2009;35:1079–83.

Garcia MS, Azari R, Eisen DB. Treatment of dermatosis papulosa nigra in 10 patients: A comparison trial of electrodesiccation, pulsed dye laser, and curettage. Dermatol Surg 2010;36:1968-72.

Niang SO, Kane A, Diallo M, Choutah F, Dieng MT, Ndiaye B. Dermatosis papulosa nigra in Dakar, Senegal. Int J Dermatol 2007;46(Suppl 1):45-7.

Karadag AS, Ozkanli S, Mansuroglu C, Ozlu E, Zemheri E. Effectiveness of the pulse dye laser treatment in a Caucasian women with dermatosis papulosa nigra. Indian J Dermatol 2015;60:321.

Katz TM, Goldberg LH, Friedman PM. Dermatosis papulosa nigra treatment with fractional photothermolysis. Dermatol Surg 2009;35:1840–3.


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