Q-switched ruby laser alone or in combination with topical flutamide for the treatment of Becker’s nevus syndrome; a randomized clinical trial

Background: Becker’s nevus syndrome (BNS) is a benign hamartoma that is aesthetically bothersome and usually appears during puberty. Various modalities of laser therapy alone or in combination with other medications can be used for the treatment of BNS, but no unified approach with an acceptable response is yet available. The current study aimed to compare the outcomes of Q-switched ruby 694 nm laser (QSRL) alone and in combination with 4% topical flutamide for the management of BNS. Methods: The current randomized clinical trial was conducted on twenty-two BNS patients between 2016-2018. The patients were randomly allocated to treatment with QSRL 694 nm alone (group A) versus in combination with 4% topical flutamide (group B). The QSRL was administered twice with four-week intervals for both groups, while group B was also administered topical flutamide 4% twice a day for eight weeks. The treatment outcomes were assessed and compared at baseline and then within 4 and 8 weeks of commencing the interventions. Results: The evaluation of the two groups in terms of lesion size alterations, response to treatment, and patients’ satisfaction showed insignificant differences between the two groups (P > 0.05). In addition, neither approach A (P = 0.33) nor approach B (P = 0.46) led to remarkable changes in lesion color. Conclusion: Based on the findings of the current study, the use of QSRL alone or even in combination with topical 4% flutamide was not suitable for the management of BNS lesions.