Background Noncultured epidermal cell suspension (NCES) is an effective surgical modality for stable vitiligo which involves transplantation of the basal layer of epidermal cells onto the dermabraded vitiliginous patch. Platelet-rich plasma (PRP) has growth factors which may stimulate melanocyte migration and proliferation of keratinocytes and fibroblasts. The objective of this study was to compare the extent of repigmentation achieved by transplantation of NCES suspended in PRP with that of NCES suspended in phosphate buffered saline (PBS).Methods Twenty-one patients of stable vitiligo with at least two lesions of comparable size were included. The two vitiligo patches were randomized to receive NCES suspended in PRP or PBS. Postoperatively after 1 week, patients were given heliotherapy for 15 minutes daily.Results At 6 months follow-up, mean repigmentation by area method in PRP arm was 75.6 AE 30% SD and in non-PRP arm was 65 AE 34% SD (P = 0.0036). Patient satisfaction by visual analogue scale at 6 months also showed better results in PRP arm (P = 0.001).Assessment by three independent observers showed better repigmentation in PRP side both at 3 and 6 months.Conclusions Suspending NCES in PRP can result in significantly greater mean repigmentation and patient satisfaction than suspending in PBS.

Results of noncultured melanocyte transplantation can be improved significantly more by suspending the melanocytes in the patients' autologous serum than in normal saline. This could be an important innovation in the surgical management of patients with stable vitiligo.

Transplantation of noncultured epidermal suspension is a safe and effective treatment for stable vitiligo in childhood. Considering its good efficacy and safety as a day-care procedure under local anaesthesia, it may be considered one of the treatments of choice for stable vitiligo in children and adolescents, especially for cases resistant to other therapies.

Rituximab is an effective agent in the treatment of pemphigus. The use of rituximab enabled use of a lower initial dose of oral prednisolone in pemphigus and hence reduced its total cumulative dose. Severe side effects were rare.

Non-cultured epidermal cell suspension transplantation was successful in producing some degree of repigmentation in our patients, and could be a useful therapy for vitiligo lesions.

Although retrograde migration of melanocytes in the improvement of leukotrichia was observed in surgical management of vitiligo, this is the first study with a large number of patients using noncultured epidermal suspension transplantation.

Background No randomized studies compared the efficacy and safety of modified Kligman's triple combination (TC) with 1,064 nm Q-switched Nd-YAG laser (QSNYL) in melasma in darker skin. Objectives To compare the efficacy and safety of QSNYL and TC in the treatment of melasma in Fitzpatrick skin types IV and V. Methods In this split face randomized controlled trial, participants' cheeks were randomized to receive either weekly QSNYL (group A) or daily TC (group B) for 12 weeks, followed by 12 weeks of follow-up. Results Twenty-eight patients completed the intervention, and 21 of them completed follow-up. We found a significant but modest reduction in mean melanin index, modified Melasma Area Severity Index (MASI), and photographic and patient's assessment in both modalities (P < 0.01). No significant differences were detected between the groups. All patients had reappearance of pigmentation by the end of follow-up. Adverse reactions were significantly more in group B (P < 0.001). Limitation The desired sample size could not be achieved. Conclusion and Relevence No statistically significant differences were observed between QSNYL and TC as monotherapy in melasma. Reappearance of melasma is inevitable after stopping treatment. Key points Question: Is Q-switched Nd-YAG laser more efficacious than modified Kligman's formulation in patients with melasma in darker skin types? Findings: Our split face randomized trial showed that a 12-week intervention with either modality led to a modest reduction in mean melanin index, modified Melasma Area Severity Index (MASI), and photographic and patient's assessment. Intermodality differences were not significant. Meaning: Treatment with Q-switched laser and Kligman's formulation as monotherapy led to a comparable and modest improvement in melasma.

ABSTRACT.Purpose: To assess the outcome of trabeculectomy supplemented with intraoperative 5-Fluorouracil (5 FU) application in glaucoma patients. Methods: A prospective non-randomized case series of 76 eyes of 76 consecutive patients who underwent trabeculectomy with intraoperative sponge 5 FU (25 mg/ ml). Minimum follow-up was 6 months. There were 31 eyes in the low-risk group and 45 eyes in the high-risk group. The reduction in intraocular pressure (IOP) and any treatment complications were noted. Results: The mean preoperative IOP was 28∫7.72 mm Hg. The mean final postoperative IOP was 16.8∫6.1 mm Hg. The average number of glaucoma medications required dropped from 1.8∫0.8 preoperatively to 0.4∫0.8 after the operation (p∞0.001). Cumulative success rates (IOP less than 21 mm Hg) for all eyes were 93% and 81% at 6 and 12 months, respectively. There was no difference in outcome between the low-and high-risk groups if criteria for success were an IOP of less than 21 mm Hg or an IOP of less than 21 mm Hg and an IOP reduction of 30%. However, if success is defined as an IOP of 15 mm Hg or less and a 30% fall in IOP, then the low-risk group had significantly longer survival times than the highrisk group (pΩ0.033, log-rank test). Transient punctate keratitis and corneal epithelial defect were each observed in only 1 eye. Other serious complications include rapid progression of cataract in 2 eyes, endophthalmitis in 1 eye and hypotonic maculopathy after subsequent cataract extraction in 1 eye. Conclusion: Single dose intraoperative 5 FU appears to be a safe and useful adjunct to trabeculectomy. IOPs in the low teens were achieved in a greater proportion of low-risk eyes than high-risk eyes.