TY - JOUR
T1 - Noninvasive treatment of cutaneous neurofibromas (cNFs)
T2 - Results of a randomized prospective, direct comparison of four methods
AU - Richey, Patricia
AU - Funk, Margaret
AU - Sakamoto, Fernanda
AU - Plotkin, Scott
AU - Ly, Ina
AU - Jordan, Justin
AU - Muzikansky, Alona
AU - Roberts, Josh
AU - Farinelli, William
AU - Levin, Yakir
AU - Garibyan, Lilit
AU - Blakeley, Jaishri O.
AU - Anderson, R. Rox
N1 - Publisher Copyright:
© 2023 American Academy of Dermatology, Inc.
PY - 2024
Y1 - 2024
N2 - Background: People with Neurofibromatosis Type 1 (NF1) suffer disfigurement and pain when hundreds to thousands of cutaneous neurofibromas (cNFs) appear and grow throughout life. Surgical removal of cNFs under anesthesia is the only standard therapy, leaving surgical scars. Objective: Effective, minimally-invasive, safe, rapid, tolerable treatment(s) of small cNFs that may prevent tumor progression. Methods: Safety, tolerability, and efficacy of 4 different treatments were compared in 309, 2-4 mm cNFs across 19 adults with Fitzpatrick skin types (FST) I-IV: radiofrequency (RF) needle coagulation, 755 nm alexandrite laser with suction, 980 nm diode laser, and intratumoral injection of 10 mg/mL deoxycholate. Regional pain, clinical responses, tumor height and volume (by 3D photography) were assessed before, 3 and 6 months post-treatment. Biopsies were obtained electively at 3 months. Results: There was no scarring or adverse events > grade 2. Each modality significantly (P < .05) reduced or cleared cNFs, with large variation between tumors and participants. Alexandrite laser and deoxycholate were fast and least painful; 980 nm laser was most painful. Growth of cNFs was not stimulated by treatment(s) based on height and volume values at 3 and 6 months compared to baseline. Limitations: Intervention was a single treatment session; dosimetry has not been optimized. Conclusions: Small cNFs can be rapidly and safely treated without surgery.
AB - Background: People with Neurofibromatosis Type 1 (NF1) suffer disfigurement and pain when hundreds to thousands of cutaneous neurofibromas (cNFs) appear and grow throughout life. Surgical removal of cNFs under anesthesia is the only standard therapy, leaving surgical scars. Objective: Effective, minimally-invasive, safe, rapid, tolerable treatment(s) of small cNFs that may prevent tumor progression. Methods: Safety, tolerability, and efficacy of 4 different treatments were compared in 309, 2-4 mm cNFs across 19 adults with Fitzpatrick skin types (FST) I-IV: radiofrequency (RF) needle coagulation, 755 nm alexandrite laser with suction, 980 nm diode laser, and intratumoral injection of 10 mg/mL deoxycholate. Regional pain, clinical responses, tumor height and volume (by 3D photography) were assessed before, 3 and 6 months post-treatment. Biopsies were obtained electively at 3 months. Results: There was no scarring or adverse events > grade 2. Each modality significantly (P < .05) reduced or cleared cNFs, with large variation between tumors and participants. Alexandrite laser and deoxycholate were fast and least painful; 980 nm laser was most painful. Growth of cNFs was not stimulated by treatment(s) based on height and volume values at 3 and 6 months compared to baseline. Limitations: Intervention was a single treatment session; dosimetry has not been optimized. Conclusions: Small cNFs can be rapidly and safely treated without surgery.
KW - cosmetic dermatology
KW - cutaneous neurofibroma
KW - laser
KW - medical dermatology
KW - mesotherapy
KW - neurocutaneous
KW - neurofibromatosis
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U2 - 10.1016/j.jaad.2023.11.058
DO - 10.1016/j.jaad.2023.11.058
M3 - Article
C2 - 38086517
AN - SCOPUS:85181834760
SN - 0190-9622
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
ER -