Management of Lymphangioma Circumscriptum via Combined Laser Therapy in Pigmented Skin: A Case Report

BACKGROUND Lymphangioma circumscriptum (LC) is a rare condition characterized by a lymphatic malformation primarily affecting the cutaneous region. Although surgical excision has historically been the first-line treatment, it may be associated with substantial complications and recurrence. This case report presents the first documented use of a simultaneous combination of erbium glass (1540 nm) and CO₂ (10 600 nm) lasers as a targeted therapeutic strategy for LC in a patient with a dark phototype. CASE REPORT A previously untreated 13-year-old Asian girl presented with a 5-month history of multiple reddish and pigmented papules located in the right medial scapular region. After histopathological confirmation, the lesions were simultaneously treated with an erbium glass (4.0 W, 1 millisecond, 4 mJ) and CO₂ (15 W, 0.25 milliseconds, 3.8 mJ) laser system, followed by topical tacrolimus (0.03%). The protocol was well tolerated, with moderate procedural pain and transient effects that resolved within 2 months. Clinical observation suggested a notable reduction in vesicles, reaching near-total clearance at the 2-month follow-up. CONCLUSIONS These results suggest that the simultaneous combination of erbium glass and CO₂ lasers represents a feasible therapeutic option for LC in patients with pigmented skin. Further investigation in larger studies with extended follow-up is required to establish long-term efficacy and safety compared with conventional surgical or laser-based standards.