{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:13:41Z","timestamp":1786115621877,"version":"build-2736575974"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Lasers Med Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Acquired bilateral nevus of Ota-like macules (ABNOM) is a common dermal melanocytosis predominantly affecting East Asian women. Q-switched (QS) and picosecond (PS) lasers are widely used, but their comparative efficacy and dose-response relationships have not been quantified. We conducted the first systematic review and dose-response meta-analysis to compare PS versus QS laser efficacy for isolated ABNOM. Eleven databases were searched from inception to May 27, 2026. Forty studies (50 treatment arms) of predominantly single-arm case series were included. The primary analysis used generalized linear mixed models (GLMM) for \u2265\u200975% clearance, complemented by dose-response meta-regression with cluster-robust standard errors. Pooled\u2009\u2265\u200975% clearance was 47.8% (95% CI 13.4\u201384.4) for PS and 53.1% (95% CI 30.3\u201374.6) for QS lasers (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.95). Each additional treatment session was associated with a 3-fold increased odds of clearance (OR 3.2; 95% CI 2.4\u20134.3;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). As an exploratory analysis, the dose-response relationship was monotonic across sessions 1\u20137. The PS estimate was fragile, ranging from 47.8% to 88.7% across sensitivity analyses. GRADE evidence certainty was very low. Treatment session number, rather than laser type, appeared more strongly associated with clearance. However, this dose-response finding remains hypothesis-generating due to very low certainty of evidence and requires validation in randomized trials. The absence of a statistically significant difference between laser types does not establish equivalence; PS efficacy estimates were highly fragile and based on sparse data. Wavelength may be an independent determinant of clearance and warrants further comparative study.\n                  <\/jats:p>","DOI":"10.1007\/s10103-026-04982-6","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:22:02Z","timestamp":1785990122000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Q-Switched and picosecond lasers for acquired bilateral nevus of Ota-like macules: a systematic review and exploratory dose-response meta-analysis"],"prefix":"10.1007","volume":"41","author":[{"given":"Feng","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufeng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoxia","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"4982_CR1","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1016\/s0190-9622(84)80313-8","volume":"10","author":"Y Hori","year":"1984","unstructured":"Hori Y, Kawashima M, Oohara K, Kukita A (1984) Acquired, bilateral nevus of Ota-like macules. J Am Acad Dermatol 10:961\u2013964. https:\/\/doi.org\/10.1016\/s0190-9622(84)80313-8","journal-title":"J Am Acad Dermatol"},{"key":"4982_CR2","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1038\/jid.2010.283","volume":"131","author":"BQ Wang","year":"2011","unstructured":"Wang BQ, Shen ZY, Fei Y et al (2011) A population-based study of acquired bilateral nevus-of-Ota-like macules in Shanghai, China. J Invest Dermatol 131:358\u2013362. https:\/\/doi.org\/10.1038\/jid.2010.283","journal-title":"J Invest Dermatol"},{"key":"4982_CR3","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1684\/ejd.2010.0918","volume":"20","author":"JY Lee","year":"2010","unstructured":"Lee JY, Lee JS, Kim YC (2010) Histopathological features of acquired dermal melanocytosis. Eur J Dermatol 20:345\u2013348. https:\/\/doi.org\/10.1684\/ejd.2010.0918","journal-title":"Eur J Dermatol"},{"key":"4982_CR4","doi-asserted-by":"publisher","DOI":"10.1111\/dth.13167","volume":"33","author":"H Kaur","year":"2020","unstructured":"Kaur H, Sarma P, Kaur S et al (2020) Therapeutic options for management of Hori\u2019s nevus: a systematic review. Dermatol Ther 33:e13167. https:\/\/doi.org\/10.1111\/dth.13167","journal-title":"Dermatol Ther"},{"key":"4982_CR5","doi-asserted-by":"publisher","first-page":"164","DOI":"10.12788\/j.sder.0117","volume":"33","author":"JR Freedman","year":"2014","unstructured":"Freedman JR, Kaufman J, Metelitsa AI, Green JB (2014) Picosecond lasers: the next generation of short-pulsed lasers. Semin Cutan Med Surg 33:164\u2013168. https:\/\/doi.org\/10.12788\/j.sder.0117","journal-title":"Semin Cutan Med Surg"},{"key":"4982_CR6","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.jaad.2017.12.053","volume":"79","author":"W Yu","year":"2018","unstructured":"Yu W, Zhu J, Yu W, Lyu D, Lin X, Zhang Z (2018) A split-face, single-blinded, randomized controlled comparison of alexandrite 755-nm picosecond laser versus alexandrite 755-nm nanosecond laser in the treatment of acquired bilateral nevus of Ota-like macules. J Am Acad Dermatol 79:479\u2013486. https:\/\/doi.org\/10.1016\/j.jaad.2017.12.053","journal-title":"J Am Acad Dermatol"},{"key":"4982_CR7","doi-asserted-by":"publisher","first-page":"3961","DOI":"10.1111\/jocd.16511","volume":"23","author":"W Chen","year":"2024","unstructured":"Chen W, Wang Z, Li Z et al (2024) Comparison of the efficacy and safety of a 730-nm picosecond titanium sapphire laser and a 1064-nm picosecond neodymium yttrium aluminum garnet laser for the treatment of acquired bilateral nevus of Ota-like macules. J Cosmet Dermatol 23:3961\u20133967. https:\/\/doi.org\/10.1111\/jocd.16511","journal-title":"J Cosmet Dermatol"},{"key":"4982_CR8","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1002\/lsm.23245","volume":"52","author":"H Ding","year":"2020","unstructured":"Ding H, Yang Y, Guo L, Lin T (2020) Use of a picosecond alexandrite laser for treating acquired bilateral nevus of Ota-like macules in Chinese patients. Lasers Surg Med 52:935\u2013939. https:\/\/doi.org\/10.1002\/lsm.23245","journal-title":"Lasers Surg Med"},{"key":"4982_CR9","doi-asserted-by":"publisher","first-page":"1671","DOI":"10.1097\/DSS.0000000000002486","volume":"46","author":"C Ungaksornpairote","year":"2020","unstructured":"Ungaksornpairote C, Manuskiatti W, Junsuwan N, Wanitphakdeedecha R (2020) A prospective, split-face, randomized study comparing picosecond to Q-switched Nd:YAG laser for treatment of epidermal and dermal pigmented lesions in Asians. Dermatol Surg 46:1671\u20131675. https:\/\/doi.org\/10.1097\/DSS.0000000000002486","journal-title":"Dermatol Surg"},{"key":"4982_CR10","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https:\/\/doi.org\/10.1136\/bmj.n71","journal-title":"BMJ"},{"key":"4982_CR11","doi-asserted-by":"publisher","first-page":"2127","DOI":"10.11124\/JBISRIR-D-19-00099","volume":"18","author":"Z Munn","year":"2020","unstructured":"Munn Z, Barker TH, Moola S et al (2020) Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evid Synth 18:2127\u20132133. https:\/\/doi.org\/10.11124\/JBISRIR-D-19-00099","journal-title":"JBI Evid Synth"},{"key":"4982_CR12","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","volume":"366","author":"JAC Sterne","year":"2019","unstructured":"Sterne JAC, Savovi\u0107 J, Page MJ et al (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 366:l4898. https:\/\/doi.org\/10.1136\/bmj.l4898","journal-title":"BMJ"},{"key":"4982_CR13","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","volume":"336","author":"GH Guyatt","year":"2008","unstructured":"Guyatt GH, Oxman AD, Vist GE et al (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336:924\u2013926. https:\/\/doi.org\/10.1136\/bmj.39489.470347.AD","journal-title":"BMJ"},{"key":"4982_CR14","doi-asserted-by":"publisher","unstructured":"Yang X, Bi C, E T, Lin L, Cao Y (2023) A retrospective study of 1064-nm Q-switched Nd:YAG laser therapy for acquired bilateral nevus of Ota-like macules. Skin Res Technol 29e13298. https:\/\/doi.org\/10.1111\/srt.13298","DOI":"10.1111\/srt.13298"},{"key":"4982_CR15","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1007\/s10103-016-1885-z","volume":"31","author":"P Yu","year":"2016","unstructured":"Yu P, Yu N, Diao W, Yang X, Feng Y, Qi Z (2016) Comparison of clinical efficacy and complications between Q-switched alexandrite laser and Q-switched Nd:YAG laser on nevus of Ota: a systematic review and meta-analysis. Lasers Med Sci 31:581\u2013591. https:\/\/doi.org\/10.1007\/s10103-016-1885-z","journal-title":"Lasers Med Sci"},{"key":"4982_CR16","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1007\/s10103-025-04721-3","volume":"40","author":"W Wu","year":"2025","unstructured":"Wu W, Du Y, Zhang Y, Su Q, Wang F (2025) Comparative appraisal with meta-analysis of picosecond versus nanosecond lasers for hyperpigmented disorders and tattoos: a systematic review and meta-analysis. Lasers Med Sci 40:465. https:\/\/doi.org\/10.1007\/s10103-025-04721-3","journal-title":"Lasers Med Sci"},{"key":"4982_CR17","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.70021","author":"W Zhao","year":"2025","unstructured":"Zhao W, Yang H, Liu X, Jiang W, Chen S, Lin T, Ge Y, Zong Y (2025) A retrospective study of picosecond alexandrite laser treatment for acquired bilateral nevus of Ota-like macules in children. Lasers Surg Med. https:\/\/doi.org\/10.1002\/lsm.70021","journal-title":"Lasers Surg Med"},{"key":"4982_CR18","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.jaad.2019.03.016","volume":"83","author":"Y Ge","year":"2020","unstructured":"Ge Y, Yang Y, Guo L, Zhang M, Wu Q, Zeng R et al (2020) Comparison of a picosecond alexandrite laser versus a Q-switched alexandrite laser for the treatment of nevus of Ota: a randomized, split-lesion, controlled trial. J Am Acad Dermatol 83:397\u2013403. https:\/\/doi.org\/10.1016\/j.jaad.2019.03.016","journal-title":"J Am Acad Dermatol"},{"key":"4982_CR19","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1097\/DSS.0000000000003542","volume":"48","author":"W Phothong","year":"2022","unstructured":"Phothong W, Manuskiatti W, Wongdama S, Gulfan MC (2022) Long-term follow-up for 1,064-nm nanosecond and picosecond laser treatment of acquired bilateral nevus of Ota-like macules. Dermatol Surg 48:1008\u20131009. https:\/\/doi.org\/10.1097\/DSS.0000000000003542","journal-title":"Dermatol Surg"},{"key":"4982_CR20","doi-asserted-by":"publisher","first-page":"e153","DOI":"10.1097\/DSS.0000000000002880","volume":"47","author":"KER Evangelista","year":"2021","unstructured":"Evangelista KER, Manuskiatti W, Wanitphakdeedecha R, Techapichetvanich T (2021) Clinical evaluation of safety and efficacy of a 670-nm picosecond laser for treatment of benign pigmented lesions in Asians. Dermatol Surg 47:e153\u2013e158. https:\/\/doi.org\/10.1097\/DSS.0000000000002880","journal-title":"Dermatol Surg"}],"container-title":["Lasers in Medical Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10103-026-04982-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10103-026-04982-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10103-026-04982-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T04:22:03Z","timestamp":1785990123000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10103-026-04982-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4982"],"URL":"https:\/\/doi.org\/10.1007\/s10103-026-04982-6","relation":{},"ISSN":["1435-604X"],"issn-type":[{"value":"1435-604X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"assertion":[{"value":"26 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Artificial intelligence tools were used for language editing and data cross-checking against predefined extraction rules. All clinical interpretations, statistical conclusions, and final manuscript content were determined by the human authors.","order":1,"name":"Ethics","label":"AI usage disclosure","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"CRD420261404917.","order":2,"name":"Ethics","label":"<b>PROSPERO registration<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"180"}}