Successful Treatment of Laser Induced Hypopigmentation with Narrowband Ultraviolet B Targeted Phototherapy
A 29-year-old male patient of Fitzpatrick skin type V approached us for tattoo removal treatment. He had a 6-month-old black tattoo of size 3 × 7 cm on the dorsum of his left hand []. He was treated with Qs 1064 nm Nd: YAG () (Dual- pulsed Q-switched Nd: YAG SPECTRA Laser, Lutronic Corporation) laser machine. The parameters used were 3 mm spot size, 2 Hz pulse rate and 3J fluence in the first session. The subsequent sessions were scheduled at 1 month interval and the fluence was gradually increased to 8J. Patient had a very good response to the treatment with 85% clearance of the tattoo but reported to us with depigmentation at 4 weeks after the 6th session of laser treatment []. Patient was then subjected to targeted UVB phototherapy twice a week starting on the same day, using TPT device (Lumera: Targeted Phototherapy, Daavlin Company), which delivered UVB radiations at a dosage of 100 mJ/s, at a full lamp output of 100 mW/cm2. The starting duration of therapy was 4 s and gradually increased by 1 s at every session, depending on the response to previous session. Patient started showing re-pigmentation after two sessions and a very good response was seen after six sessions at 9 s duration of phototherapy []. The energy delivered at 9 s with the Lumera system was 275 mJ/cm2.