Two days after undergoing...

Two days after undergoing a long-pulsed 755-nm alexandrite LHR operation, a 50-year-old woman (skin phototype III) presented to our clinic with a mildly itchy skin eruption over her bilateral lower extremities. A clinical examination of her thighs and legs revealed several non-blanching erythematous papules. Instead of submitting to a skin biopsy, she consented to less invasive provocation testing on her unaffected right forearm using a lower parameter setting. A mildly positive response was seen to a long-pulsed alexandrite laser at 755 nm, a solid answer to a long-pulsed neodymium-doped yttrium aluminium garnet (Nd: YAG) laser at 1064 nm, and adverse reactions to tests using ice, cryogen (1,1,1,2 tetrafluoroethane), and liquid nitrogen (LN).