Long-Pulsed Alexandrite Laser for Scrotal Angiokeratomas: Efficacy and Safety in a Clinical Study.

INTRODUCTION: Scrotal angiokeratomas or Angiokeratoma of Fordyce (AF) are benign vascular lesions that may cause cosmetic concerns and recurrent bleeding, prompting patients to seek treatment. Various laser modalities have been explored for their management, but data on the efficacy of the long-pulsed alexandrite laser (755 nm) in treating symptomatic cases remain limited. OBJECTIVE: This study aimed to evaluate the efficacy and safety of long-pulsed alexandrite laser for the treatment of symptomatic AF. METHODS: This was a nonrandomized interventional observational study conducted at a dermatology clinic in a private hospital. Ten symptomatic male patients (n = 10; aged 25-67 years) with histologically confirmed scrotal angiokeratomas underwent two to three sessions of long-pulsed alexandrite laser treatment. Clinical outcomes were assessed over a 3-month follow-up period, including lesion clearance, symptom resolution, patient satisfaction, and adverse effects. Statistical analysis was performed using the Wilcoxon signed-rank test. RESULTS: Among the 10 patients, 7 (70%) achieved measurable clearance, including 5 (50%) with near-complete resolution and 2 (20%) with moderate improvement. Three patients (30%) showed no improvement in lesion clearance. Recurrent bleeding was initially reported by nine patients (90%); all experienced reduced frequency, and most reported complete cessation. Adverse effects occurred in five patients (50%), with some experiencing more than one event (erythema, scarring, or hypopigmentation), accounting for cumulative percentages exceeding 100%. A significant improvement in clearance was confirmed by the Wilcoxon signed-rank test (p = 0.0118). CONCLUSION: Long-pulsed Alexandrite laser demonstrated high efficacy and safety in treating symptomatic scrotal angiokeratomas, achieving significant lesion clearance and symptom relief with minimal adverse effects. This study supports its role as a noninvasive alternative to surgical approaches, although larger, randomized studies are recommended to validate these findings.