{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T05:20:26Z","timestamp":1787980826520,"version":"build-2784847793"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust J Dermatology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Acquired bilateral naevus of Ota\u2010like macules (ABNOM), also known as Hori's naevus, is a common dermal melanocytosis causing facial hyperpigmentation. While the 755\u2010nm Q\u2010switched alexandrite lasers (QSAL) are traditionally used, they are limited by moderate clearance and substantial risk of post\u2010inflammatory hyperpigmentation (PIH). This systematic review and meta\u2010analysis evaluate the efficacy and safety of the 755\u2010nm picosecond alexandrite laser (PSAL) for ABNOM. Embase via Ovid, MEDLINE, PubMed, Scopus, Cochrane, Web of Science and CiNAHL were searched from inception to April 14, 2026, according to Preferred Reporting Items for Systematic Reviews and Meta\u2010analyses (PRISMA) guidelines. The review was prospectively registered on PROSPERO (CRD420261379083). Studies reporting efficacy or safety outcomes following PSAL treatment for ABNOM were included. Statistical analyses were performed using a random\u2010effects model. Six studies comprising 318 patients (94.6% female, predominantly Fitzpatrick skin types III\u2010IV) were included. After excluding studies at critical risk of bias from quantitative pooling, the pooled first\u2010session near\u2010complete (&gt;\u200990%\u201395%) clearance rate was 8.8% (95% CI 5.9%\u201312.7%;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090%). Clearance rates improved progressively with additional sessions. The overall pooled PIH rate was 21.1% (95% CI 17.1%\u201326.1%;\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090%), with all cases being transient. Hypopigmentation (0.6%) and scarring (0%) were rare. Numerically lower PIH rates were observed in the paediatric cohort (16.3%) compared with adults (22.2%). PSAL provides an effective treatment for ABNOM with progressive pigment clearance over multiple sessions and a favourable safety profile. Multiple sessions are typically required for optimal results. Further high\u2010quality RCTs with standardised protocols and long\u2010term follow\u2010up are warranted.\n                  <\/jats:p>","DOI":"10.1111\/ajd.70203","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T05:07:01Z","timestamp":1787980021000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of 755\u2010nm Picosecond Alexandrite Laser for Acquired Bilateral Naevus of Ota\u2010Like Macules (Hori Naevus): A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4095-4605","authenticated-orcid":false,"given":"Kangjie R.","family":"Chua","sequence":"first","affiliation":[{"name":"Royal Prince Alfred Hospital  Camperdown New South Wales Australia"},{"name":"The University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3535-6546","authenticated-orcid":false,"given":"Mohammad","family":"Ghotmi","sequence":"additional","affiliation":[{"name":"Doncaster Royal Infirmary  Doncaster UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-7401","authenticated-orcid":false,"given":"Dilip K.","family":"Vankayalapati","sequence":"additional","affiliation":[{"name":"Wollongong Hospital  Wollongong New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9813-2286","authenticated-orcid":false,"given":"Konstantinos","family":"Baronos","sequence":"additional","affiliation":[{"name":"Department of General Surgery University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1536-0226","authenticated-orcid":false,"given":"Emma J. B.","family":"Nordahl","sequence":"additional","affiliation":[{"name":"Department of General Surgery Helse Fonna Hospital Trust  Haugesund Norway"},{"name":"University of Nicosia Medical School University of Nicosia  Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5904-9927","authenticated-orcid":false,"given":"Alma","family":"Sato","sequence":"additional","affiliation":[{"name":"University of Nicosia Medical School University of Nicosia  Nicosia Cyprus"},{"name":"Department of Orthopaedic Surgery, School of Medicine Sapporo Medical University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7584-1662","authenticated-orcid":false,"given":"Sum\u2010Yu C.","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Nicosia Medical School University of Nicosia  Nicosia Cyprus"},{"name":"University of Leicester Hospitals NHS Trust, Leicester Royal Infirmary, Infirmary Square  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4193-9925","authenticated-orcid":false,"given":"Christian A.","family":"Than","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital  Cambridge UK"},{"name":"School of Biomedical Sciences The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5946-1786","authenticated-orcid":false,"given":"Davin","family":"Lim","sequence":"additional","affiliation":[{"name":"The Skin Hospital  Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/j.1365-2133.1987.tb07485.x","article-title":"Naevus Fusco\u2010Caeruleus Zygomaticus","volume":"117","author":"Sun C.\u2010C.","year":"1987","journal-title":"British Journal of Dermatology"},{"key":"e_1_2_14_3_1","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.jaad.2008.10.054","article-title":"Acquired Bilateral Nevus of Ota\u2010Like Macules (Hori Nevus): Etiologic and Therapeutic Considerations","volume":"61","author":"Park J. M.","year":"2009","journal-title":"Journal of the American Academy of Dermatology"},{"key":"e_1_2_14_4_1","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/S0190-9622(84)80313-8","article-title":"Acquired, Bilateral Nevus of Ota\u2010Like Macules","volume":"10","author":"Hori Y.","year":"1984","journal-title":"Journal of the American Academy of Dermatology"},{"key":"e_1_2_14_5_1","doi-asserted-by":"crossref","first-page":"e13167","DOI":"10.1111\/dth.13167","article-title":"Therapeutic Options for Management of Hori's Nevus: A Systematic Review","volume":"33","author":"Kaur H.","year":"2020","journal-title":"Dermatologic Therapy"},{"key":"e_1_2_14_6_1","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1097\/01.JD9.0000559836.07162.f2","article-title":"Effects of Q\u2010Switched Laser Treatments on Acquired Bilateral Nevus of Ota\u2010Like Macules: A Retrospective Comparative Study","volume":"2","author":"Zeng R.","year":"2019","journal-title":"Journal of Dermatology and Venereology"},{"key":"e_1_2_14_7_1","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1067\/mjd.2003.193","article-title":"Treatment of Acquired Bilateral Nevus of Ota\u2010Like Macules (Hori's Nevus) Using a Combination of Scanned Carbon Dioxide Laser Followed by Q\u2010Switched Ruby Laser","volume":"48","author":"Manuskiatti W.","year":"2003","journal-title":"Journal of the American Academy of Dermatology"},{"key":"e_1_2_14_8_1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1046\/j.1524-4725.2000.99305.x","article-title":"Treatment of Hori's Nevus With the Q\u2010Switched Nd:YAG Laser","volume":"26","author":"Polnikorn N.","year":"2000","journal-title":"Dermatologic Surgery"},{"key":"e_1_2_14_9_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s10103-021-03257-6","article-title":"Efficacy and Safety of 755 Nm Q\u2010Switched Alexandrite Laser for Hori's Nevus: A Retrospective Analysis of 482 Chinese Women","volume":"37","author":"Huang L.","year":"2022","journal-title":"Lasers in Medical Science"},{"key":"e_1_2_14_10_1","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/lsm.22540","article-title":"The Histology of Skin Treated With a Picosecond Alexandrite Laser and a Fractional Lens Array: Histology With a Fractional Picosecond Alexandrite Laser","volume":"48","author":"Tanghetti E. A.","year":"2016","journal-title":"Lasers in Surgery and Medicine"},{"key":"e_1_2_14_11_1","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.jaad.2017.12.053","article-title":"A Split\u2010Face, Single\u2010Blinded, Randomized Controlled Comparison of Alexandrite 755\u2010Nm Picosecond Laser Versus Alexandrite 755\u2010Nm Nanosecond Laser in the Treatment of Acquired Bilateral Nevus of Ota\u2013Like Macules","volume":"79","author":"Yu W.","year":"2018","journal-title":"Journal of the American Academy of Dermatology"},{"key":"e_1_2_14_12_1","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1002\/lsm.23245","article-title":"Use of a Picosecond Alexandrite Laser for Treating Acquired Bilateral Nevus of Ota\u2010Like Macules in Chinese Patients","volume":"52","author":"Ding H.","year":"2020","journal-title":"Lasers in Surgery and Medicine"},{"key":"e_1_2_14_13_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses: The PRISMA Statement","volume":"6","author":"Moher D.","year":"2009","journal-title":"PLoS Medicine"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_14_16_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2024"},{"key":"e_1_2_14_17_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1136\/ebmental-2019-300117","article-title":"How to Perform a Meta\u2010Analysis With R: A Practical Tutorial","volume":"22","author":"Balduzzi S.","year":"2019","journal-title":"Evidence\u2010Based Mental Health"},{"key":"e_1_2_14_18_1","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring Inconsistency in Meta\u2010Analyses","volume":"327","author":"Higgins J. 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R.","year":"2026","journal-title":"Australasian Journal of Dermatology"},{"key":"e_1_2_14_31_1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.3109\/09546634.2011.560929","article-title":"Effect of Spot Size and Fluence on Q\u2010Switched Alexandrite Laser Treatment for Pigmentation in Asians: A Randomized, Double\u2010Blinded, Split\u2010Face Comparative Trial","volume":"23","author":"Wang C.\u2010C.","year":"2012","journal-title":"Journal of Dermatological Treatment"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2026.05.088"},{"key":"e_1_2_14_33_1","doi-asserted-by":"crossref","first-page":"259","DOI":"10.2147\/CCID.S450081","article-title":"Cosmetic Considerations in Dark\u2010Skinned Patients","volume":"17","author":"Harnchoowong S.","year":"2024","journal-title":"Clinical, Cosmetic and Investigational Dermatology"}],"container-title":["Australasian Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajd.70203","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajd.70203","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajd.70203","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T05:07:07Z","timestamp":1787980027000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ajd.70203"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":32,"alternative-id":["10.1111\/ajd.70203"],"URL":"https:\/\/doi.org\/10.1111\/ajd.70203","archive":["Portico"],"relation":{},"ISSN":["0004-8380","1440-0960"],"issn-type":[{"value":"0004-8380","type":"print"},{"value":"1440-0960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]},"assertion":[{"value":"2026-07-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ajd.70203"}}