Noncultured epidermal cell suspension (NCES) is a well‐established surgical treatment modality for stable vitiligo. The outcome of this procedure significantly depends on the method of recipient site preparation, a critical step to achieve cosmetically acceptable repigmentation. To compare the efficacy of recipient site preparation using three methods namely, dermabrasion, cryoblister, and dermaroller followed by NCES in stable vitiligo. In this single‐center, prospective, intra‐patient, randomized clinical trial; 36 participants having at least three vitiligo patches in same anatomic region with minimum lesional stability of 1 year were randomized 1:1:1 for recipient site preparation using manual dermabrasion, cryoblister, and dermaroller followed by NCES. Patients were followed up at 4, 8, and 12 weeks and assessment of extent and pattern of repigmentation, color match and patient satisfaction were done. Among 36 patients, 22 (61.1%) were females; mean (SD) age was 28.33 (9.4) years. Dermabrasion and cryoblister techniques showed equal efficacy with respect to extent of repigmentation (>75% repigmentation; 55.6% vs 47.2%; P = .63) and patient satisfaction score (20.2 ± 9.6 vs 19.9 ± 7.9, P = .194). However, dermabrasion was superior to cryoblister in terms of rapidity (65% vs 32.5% at 4 weeks, P = .04) and color match (47.2% vs 19.4%, P = .004). Dermaroller had poor repigmentation outcomes compared to both dermabrasion and cryoblister. Cryoblister as a method of recipient site preparation is equally effective as manual dermabrasion in NCES for attaining good to excellent repigmentation, but with risk of hyperpigmentation. However, dermaroller is inferior to both dermabrasion and cryoblister.

Hyperpigmentation is one of the common pigmentary complaints that brings the patient to dermatology services. Though there are multiple etiologies for hyperpigmentation, pigmented contact dermatitis (PCD) remains a common diagnosis. The cosmetics containing dyes, preservatives, fragrances, bactericidal, emulsifiers/surfactants, and vehicles are the potential sources, and paraphenylenediamine, benzyl salicylate, brilliant lake red R, thiomersal and gallate mix are some of the most commonly implicated allergens. The clinical manifestation includes diffuse or patchy brown to blue-black pigmentation of the cheeks, the outer surface of ears, preauricular region, temporal area, nape of the neck, and upper back. Patch testing plays a pivotal role in the diagnosis of PCD and the testing series has to be selected according to the representative population. Given the chronicity of the disease, counseling patients against the use of cosmetics is challenging as the pigmentation tends to persist for longer durations inspite of stopping cosmetics. The pillars of treatment in PCD include recognition of the culprit allergen and preventing further exposure along with pharmacological therapy. This review provides a brief overview and an insight into the etiopathogenesis and management of PCD.

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BackgroundAcral vitiligo is a significantly distressing condition and tends to be treatment‐resistant. The occurrence of new lesions on acral areas further causes greater psychological trauma. Topical tacrolimus has been widely used in the management of vitiligo and its role in preventing flares in other dermatoses such as atopic dermatitis has been well documented.ObjectivesTo assess the role of topical tacrolimus as preventive therapy in unstable acral vitiligo.Materials and MethodsIn this single‐centre randomized prospective study, 60 patients aged 16–60 years having unstable acral vitiligo with symmetrical lesions were enrolled and randomized (1:1) into two groups. Patients in group A were instructed to apply topical tacrolimus 0.1% ointment on both vitiliginous and normal skin while patients in group B were instructed to apply topical tacrolimus 0.1% ointment only on vitiliginous skin for 6 months. Only the distal hand till the wrist joint was chosen for observation. Vitiliginous patches were assessed monthly for 6 months for a change in the number of lesions and total area involved, extension of preexisting lesions and adverse effects if any.ResultsA reduction in the number of lesions was observed in both groups. The decrease in the number of lesions in group A was 5.6% as compared to 2.3% in group B (p‐0.001). The decrease in depigmented area in group A was 10.5% as compared to 4.6% in group B (p‐0.048). Treatment failure was seen in 11 out of 60 (18.3%) patients.ConclusionTacrolimus 0.1% ointment application showed effectiveness in preventing the appearance of new lesions in unstable acral vitiligo and hastening the repigmentation when applied on both lesional and perilesional skin in vitiligo.

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