Prospective cohort study assessing the efficacy of dermoscopy-guided combination therapy using CO2 and 1064-nm lasers for junctional nevus

Background Junctional nevus is a common benign cutaneous tumor with a potential risk of malignant transformation. Traditional CO 2 laser treatment often leads to residual lesions and recurrence due to limited vaporization depth. Dermoscopy enables real-time visualization of lesions, while the 1064-nm laser specifically targets melanin. This study evaluates the efficacy and safety of dermoscopy-assisted CO 2 laser therapy combined with 1064 nm laser treatment for junctional nevus. Methods From January 2023 to October 2024, 153 patients diagnosed with junctional nevus were recruited and allocated into an experimental group ( n = 77) and a control group ( n = 76). The control group received CO 2 laser treatment guided by naked-eye observation, while the experimental group underwent dermoscopy-assisted CO 2 laser therapy combined with 1064 nm laser treatment. Clinical efficacy, wound healing, pain levels, scar formation, patient satisfaction, and recurrence rates were assessed during a 6-month follow-up. Results The total effective rate in the experimental group was 96.10%, which was significantly higher than the 86.84% observed in the control group (χ 2 = 4.220, P = 0.040). Vancouver Scar Scale (VSS) scores in the experimental group were significantly lower than those in the control group at both 1 week (6.47 ± 1.08 vs. 7.82 ± 1.02; t = 7.947, P < 0.001) and 1 month (3.02 ± 0.39 vs. 3.81 ± 0.48; t = 11.18, P < 0.001) post-treatment. Patient satisfaction with aesthetics (96.10%) and treatment efficacy (94.80%) was higher in the experimental group compared to the control group (aesthetics: 86.84%, χ 2 = 4.220, P = 0.040; treatment efficacy: 84.21%, χ 2 = 4.585, P = 0.032), whereas satisfaction with comfort did not differ significantly. Recurrence rates at 2 months (2.60%) and 6 months (7.80%) post-treatment were significantly lower in the experimental group than in the control group (2 months: 10.53%, χ 2 = 3.936, P = 0.047; 6 months: 22.37%, χ 2 = 6.362, P = 0.012). Conclusion The combination of dermoscopy-assisted CO 2 laser and 1064 nm laser therapy for the treatment of junctional nevus enhances therapeutic efficacy, diminishes scar severity, increases patient satisfaction, and reduces recurrence rates.