Pigmentary diseases include both acquired and genetic forms and can present with either decrease or increase in pigmentation. Nutritional and metabolic diseases like sarcoidosis have important cutaneous manifestations whereas many internal malignancies have telltale signs in skin. Some genodermatoses have classical features like neurofibromas in neurofibromatosis and ash-leaf macules in tuberous sclerosis. Ichthyoses are fish like scaling of skin and can result from genetic abnormalities or can be acquired later in diseases like sarcoidosis and lymphomas. Skin is also itself diseased with both benign tumors like dermatofibroma and malignancies like squamous cell carcinoma. Lasers are new addition to the therapeutic armamentarium of dermatological diseases and a brief understanding of lasers is offered herein.