{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:27:52Z","timestamp":1754144872507,"version":"3.41.2"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Post\u2010laser melasma induction\/exacerbation remains a critical challenge in treating acquired bilateral nevus of Ota\u2010like macules (ABNOMs). While laser parameters are well\u2010studied, patient\u2010specific risk factors across evolving therapeutic eras require elucidation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort analyzed 2675 ABNOMs patients treated with Q\u2010switched lasers in two eras: C1 (2010\u20132013; 1064\u2009nm\u2010only, <jats:italic>n<\/jats:italic>\u2009=\u20091069) and C2 (2020\u20132023; multi\u2010wavelength, <jats:italic>n<\/jats:italic>\u2009=\u20091606). Risk factors were assessed through multivariate logistic regression, incorporating laser wavelength stratification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Era\u2010specific risk reversals emerged: In C1, age &gt;\u200925, Fitzpatrick IV and patch lesions predicted melasma induction, whereas large\/dark lesions showed protective effects. C2 showed inverse risks for lesion characteristics (large\/dark lesions showed negative effects), with skin type\/age becoming nonsignificant. Despite increased number of patients with pre\u2010existing melasma in C2, melasma exacerbation rates decreased from 87.6% (C1) to 50.1% (C2, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) in parallel with diagnostic advances (subclinical melasma detection) and protocol optimization. Wavelength\u2010specific analysis revealed a persistent Fitzpatrick IV risk with 1064\u2009nm versus lesion\u2010driven risks with 694\/755\u2009nm. Paradoxically, treatment of dark lesions with 1064\u2009nm reduced the risk of melasma exacerbation, probably through selective melanin targeting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ABNOMs\u2010related melasma risks dynamically evolve with diagnostic\/therapeutic advancements, demanding phenotype\u2010specific laser parameter selection. This decade\u2010spanning analysis provides actionable insights for optimizing laser therapy in diverse ABNOMs populations, despite inherent retrospective limitations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p>Registry and the Registration No. of the study\/trial: ChiCTR2500095697.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.70024","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T01:04:24Z","timestamp":1747962264000},"page":"466-476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Acquired Bilateral Nevus of Ota\u2010Like Macules Patients' Clinical Characteristics and Melasma Induction\/Exacerbation After Q\u2010Switched Laser: A Decadal Comparative Study of 2675 Chinese Women in Two Different Periods"],"prefix":"10.1002","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3618-8473","authenticated-orcid":false,"given":"Ying","family":"Li","sequence":"first","affiliation":[{"name":"Department of Dermatology Xiangya Hospital Central South University Changsha Hunan China"},{"name":"Hunan Key Laboratory of Aging Biology, Xiangya Hospital Central South University Changsha Hunan China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital Central South University Changsha Hunan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Dermatology Xiangtan Central Hospital Xiangtan Hunan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiran","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Dermatology Xiangya Hospital Central South University Changsha Hunan China"},{"name":"Hunan Key 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