A comparative study of 30% Trichloroacetic acid chemical peel with Q switched Nd-YAG laser 1064nm in the treatment of Macular amyloidosis

Abstract

Macular amyloidosis (MA) is the subtlest of the cutaneous varieties of amyloidosis. In general, the treatment of MA is disappointing. Hence, this study was aimed at comparing the two treatment modalities for the same. To compare the efficacy of 30% TCA chemical peel with Q switched Nd-YAG laser 1064nm in the treatment of macular amyloidosis. 50 patients of MA attending our Dermatology outpatient department were enrolled in the study. The study involved application of 30% TCA in 25 patients at an interval of 2 weeks for 10 sittings and Q switched Nd-YAG laser 1064 in 25 patients at an interval of 1 month for 5 sittings. Digital photographs were taken before treatment and then periodically. The response was graded percentage of reduction in pigmentation both by the patient and the observer. The patients were followed up for 5 months post treatment for recurrence. Both TCA peel and Q switched Nd-Yag laser 1064nm were effective in the treatment of macular amyloidosis. switched Nd-Yag laser 1064nm showed better response compared to TCA peel at the end of the treatment, both by subjective and objective methods and in terms of less number of sittings and fewer side effects. The difference was statistically significant (P <0.05).No permanent side effects were seen in any of the treated patients and the improvement was sustained without any relapse at 5 months except in one patient in the peel group. Both these treatment modalities are effective and safe in the treatment of MA. Q switched Nd-Yag laser 1064nm was found to be marginally superior to TCA peel.