Journal of Asia Pacific Aesthetic Sciences

Abstract: Nevus spilus (NS), or speckled lentiginous nevus, is a pigmented skin lesion characterized by darker macules within a lighter brown patch. Managing NS is challenging due to its cosmetic impact, recurrence risk, and the need for selective pigment targeting without scarring. Among available treatment modalities, the Q-switched Nd:YAG laser (QSNYL) is considered an effective option, as it selectively targets melanin with minimal collateral tissue damage, offering favorable cosmetic outcomes. We report the case of a 37-year-old woman with NS presenting as hyperpigmentation on the preauricular region. The first two sessions of combination treatment with 660 nm and 1064 nm QSNYL resulted in post-inflammatory hyperpigmentation (PIH), which progressively worsened after the third and fourth sessions with 532 nm and 1064 nm QSNYL. Treatment was subsequently switched to the 1064 nm wavelength alone, which led to improvement of both the NS lesion and PIH, with no adverse effects. This case highlights the potential role of QSNYL in the management of NS.

Keywords: Nevus Spilus, Q-switched Nd:YAG 1064nm laser, Post-inflammatory hyperpigmentation