Fibrofolliculomas in Birt-Hogg-Dubé syndrome treated with a CO<sub>2</sub> and dye laser combination: a case report and literature review

Birt-Hogg-Dubé syndrome (BHD) can cause benign skin lesions such as fibrofolliculomas, as well as systemic manifestations including pulmonary cysts, kidney tumors, and recurrent pneumothoraces. We report the successful treatment of fibrofolliculomas in a patient with BHDs using a combination of fractionated ablative CO2 laser and a flash lamp pulsed dye laser (FPDL). This combined method improves the CO2 healing process's functional and cosmetic results; the first wavelength (ablative) has a greater capacity for excision and tissue regeneration, while the second (non-ablative) provides more control over the tissue healing process. The lesions were ablated up to the papillary dermis without enhancing the overall textural appearance. Therefore, deeper laser ablations may be able to stop dermal residual lesion relapses. In conclusion, fractionated CO2 laser and FPDL can be used safely and effectively to reduce the appearance of facial hamartomas related to BHDs.