Journal of Asia Pacific Aesthetic Sciences

Abstract: The concurrent presence of melasma and acquired bilateral nevus of Ota- like macules (ABNOM) presents unique challenges in dermatological treatment, as both conditions involve pigmented lesions but require distinct approaches. This case report discusses the treatment of a patient with ABNOM and concomitant dermal melasma using the 1064-nm Q-switched Nd:YAG laser (QSNYL). We report a 50-year-old female patient with Fitzpatrick type IV presented at our clinic with both ABNOM and dermal melasma. She was treated with 1064-nm QSNYL for 20 sessions over 21 months, with treatment intervals ranging from 4 to 6 weeks. The outcome showed significant improvement in both ABNOM and melasma, as evidenced by the clearance of ABNOM lesions and a reduction in the modified Melasma Area and Severity Index (mMASI) score, which decreased from 21.60 at the initial consultation to 6.40 over 21 months. In conclusion, our findings suggest the potential efficacy of 1064- nm QSNYL in treating patients with both ABNOM and dermal melasma in a Malaysian population. Further studies are needed to determine the efficacy and safety of 1064-nm QSNYL in treating larger cohorts of patients with ABNOM and concurrent melasma.