https://www.selleckchem.com/products/ki20227.html 3 rearrangement. Cutaneous CD30+ lymphoproliferative diseases with 6p25.3 rearrangement may have the same biphasic histopathological pattern and favorable prognosis, although a variety of clinical manifestations ranging from LyP to pcALCL and even anaplastic lymphoma kinase negative systemic ALCL with secondary cutaneous involvement may be observed. Cutaneous CD30+ lymphoproliferative diseases with 6p25.3 rearrangement may have the same biphasic histopathological pattern and favorable prognosis, although a variety of clinical manifestations ranging from LyP to pcALCL and even anaplastic lymphoma kinase negative systemic ALCL with secondary cutaneous involvement may be observed. Q-switched NdYAG (QS-NdYAG) toning (low fluence, large spot size, and high frequency) has been used successfully for the treatment of melasma, especially in dark skin phototypes. Punctate leukoderma was found to be a frequent complication that reduced the safety of this procedure. Combining low power fractional CO laser, which is another effective melasma laser therapy, might improve the efficacy and safety of this procedure. The aim of this study was to evaluate the effect of combining low power fractional CO laser with QS-NdYAG toning in the treatment of melasma. A randomized comparative split-face study included a total of 30 patients with bilateral, symmetrical melasma. All patients received QS-NdYAG toning on one randomly selected side of the face, while the other side randomly received either low power fractional CO alone (group A) or combined QS-NdYAG toning with low power fractional CO (group B). QS-NdYAG toning sessions were scheduled every two weeks for nine consecutive sessions, and lowore effective than low power fractional CO in the treatment of melasma when used separately. Although combining low power fractional CO with QS-NdYAG toning does not increase its efficacy, it minimizes the incidence of the undesirable punctate leukode