Kristine Heidemeyer, Laurence Feldmeyer, Irene Raeber, Nathalie Dietrich, Simone Cazzaniga, Nikhil Yawalkar, S. Morteza Seyed Jafari, Luca Borradori, Maurice Adatto
DOI: 10.2340/00015555-3503

Intravenous ferric carboxymaltose is increasingly used to treat iron deficiency. However, a common side-effect is paravenous extravasation of iron preparations, resulting in cutaneous siderosis. Quality-switched (QS) lasers and, recently, picosecond (PS) lasers have been used to treat these hyperpigmentations with variable success. The optimal treatment protocol remains unclear. The aims of this study were to assess the response of cutaneous siderosis to treatment with pigment lasers and to determine the optimal wavelength, number of treatment sessions and pulse duration. Fifteen patients with cutaneous siderosis on the arms were included. The effectiveness of laser treatment was evaluated using a 5-point standard Physician Global Assessment (PGA) grading system. Differences in continuous variables between distinct groups of patients were assessed with a Mann–Whitney U test. In all 15 patients clearance of at least 50% was obtained. In 12 patients, at least 75% of pigment was removed. In conclusion, pigment lasers are an effective and safe method to treat cutaneous siderosis.

Intravenous iron solution drugs are increasingly used to treat iron deficiency. A rare side-effect is paravenous extravasation of iron preparations, resulting in cutaneous siderosis. Pigment-targeting lasers have been used to treat these hyperpigmentations with variable success. The optimal treatment protocol remains unclear. This retrospective study with 15 patients aimed to assess the response of cutaneous iron deposit after treatment with pigment lasers and to determine optimal treatment parameters. The effectiveness of laser treatments was evaluated using a 5-point grading system. In all 15 patients a clearance of at least 50% was obtained. In 12 patients, at least 75% of pigment was removed.