A prospective, randomized clinical study to compare the efficacy of recipient site preparation using dermabrasion, cryoblister, and dermaroller in autologous noncultured epidermal cell suspension in stable vitiligo

Abstract

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.

Surgical procedures and innovative approaches for vitiligo regenerative treatment and melanocytorrhagy

“…In cellular grafting methods, melanocytes were isolated from normal skin of patients and expanded in vitro before transplantation. 24 Cellular transplantation has been a unique surgical technique in the last few decades to treat stable vitiligo in patients who do not respond to alternative therapies such as pharmacologic therapy, immunotherapy, phototherapy, photochemotherapy, and tissue grafting methods. A systematic review and meta-analysis suggested that surgical intervention could be an effective option for refractory stable vitiligo.…”

Electrofulguration‐assisted dermabrasion is comparable to manual dermabrasion in patients undergoing autologous non‐cultured epidermal cell suspension for treatment of stable vitiligo: A randomized controlled trial

“…Successful repigmentation was defined as repigmentation greater than 75% and excellent repigmentation as greater than 90%. This semi‐objective method was chosen in order to maintain uniformity with respect to prior studies 10‐13 . Objective evaluation of the clinical response was also done by calculating VASI in lesions of both groups (target VASI) at each follow‐up visit.…”

“…This semi-objective method was chosen in order to maintain uniformity with respect to prior studies. [10][11][12][13] Objective evaluation of the clinical response was also done by calculating VASI in lesions of both groups (target VASI) at each follow-up visit. An improvement in VASI of >50% from baseline was considered as "very much improved".…”

Vitiligo: Translational research and effective therapeutic strategies

“…(Awasti et al., 2019; Rasheed et al., 2020) Recipient site preparation in vitiligo surgery is of equal importance and a recent randomized clinical trial of NCES comparing different recipient site preparation methods has shown a good results with manual dermabrasion and cryoblister. (Subburaj et al., 2020) Other methods such as electrofulguration‐assisted dermabrasion, (Kumar et al., 2020) erbium:YAG laser or CO 2 laser, (Al‐Hadidi et al., 2015) and dermaroller‐assisted (Benzekri & Gauthier, 2017) recipient site preparation have been tried. Dermal mesenchymal cells have shown immunomodulatory effects in vitiligo and a study comparing non‐cultured dermal cell suspension in combination with NCES showed good repigmentation in vitiligo with the stability of 3–6 months as compared to NCES alone.…”