To evaluate long-term efficacy and safety of melanocyte-keratinocyte cell transplantation in the management of segmental and focal vitiligo.Design: A simpler and modified method based on that of OlssonandJuhlinwasperformed.Thismethodusesashaved biopsy skin sample up to one tenth the size of the recipient area. The skin sample is incubated, and the cells are mechanically separated using trypsin-EDTA solution and then centrifuged to prepare a suspension. Cell suspension is then applied to the dermabraded depigmented skin area, and a collagen dressing is applied to keep it in place.Patients: Fifty patients with segmental and 17 with focal vitiligo were treated. One patient with segmental and 2 with focal vitiligo did not attend any follow-up visits. The remaining patients were observed for a period of up to 5 years.Intervention: Autologous, noncultured melanocytekeratinocyte cell transplantation.Main Outcome Measure: Repigmentation was graded as excellent with 95% to 100% pigmentation, good with 65% to 94%, fair with 25% to 64%, and poor with 0% to 24% of the treated area.Results: In the segmental vitiligo group, 41 patients (84%) showed excellent, 3 (6%) good, and 5 (10%) poor pigmentation, which was retained until the end of the respective follow-up period. In the focal vitiligo group, 11 patients (73%) showed excellent, 1 (7%) fair, and 3 (20%) poor pigmentation, which was retained until the end of the respective follow-up period.Conclusions: Melanocyte-keratinocyte cell transplantation is a simple, safe, and effective surgical therapy. Patients with segmental and focal vitiligo can experience a prolonged disease-free period, which may extend through the rest of their lives.

This surgical treatment gives its best results in segmental and focal vitiligo, even with large affected areas, and in at least 50% of patients with generalized vitiligo, thus improving their appearance.

SummaryBackground Vitiligo is a disfiguring disease, characterized frequently by the presence of de-pigmented macules and/or patches. Traditional therapies are essentially medical and are most preferred by dermatologists. Surgical therapies, however, are amongst the most effective interventions for vitiligo but are limited by their invasive nature, as well as the training and expertise needed to perform specific procedures. Objectives To assess the evidence for the effectiveness, safety and applicability of the various surgical methods in the treatment of vitiligo. Methods For this systematic review of vitiligo surgical therapies, our searches included: PubMed, MEDLINE and Cochrane databases. Results We reviewed research studies reporting on split thickness skin grafts (STSG), punch/mini-graft, blister roof grafting, cultured and non-cultured cellular transplantation (MKTP). While all methods vary in their repigmentation outcomes, STSG is found to have the highest repigmentation success rate. Overall, post-operative complications included milia, scarring, cobblestone appearance or hyperpigmentation of treated areas. Conclusion This review highlights the need for more randomized controlled trials in this field, underpinned by a more standardized objective approach to the assessment of repigmentation following surgical interventions.

One hundred and forty-two patients with vitiligo vulgaris were treated and observed for a period up to 6 years. Eighty (56%) patients showed excellent, 15 (11%) showed good, 13 (9%) showed fair and 34 (24%) showed poor repigmentation, which was retained till the end of the respective follow-up period.

No abstract