Koebner Phenomenon in Vitiligo: Not Always an Indication of Surgical Failure

Mulekar, Sanjeev V.

doi:10.1001/archderm.143.6.801

Cited by 17 publications

(13 citation statements)

References 3 publications

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“…According to the literature, most authors classified vitiligo as being stable when further progression of lesions or development of new lesions has been absent for the past year (van Geel et al., 2004b). However, the absence of clinical progression may not correspond to the situation at a cellular level [e.g., production of inflammatory cytokines (TNF‐α IL‐1, IL‐6), expression of ICAM‐1], which may carry a predisposition to develop depigmentation after minor trauma (Abdallah et al., 2003; Mulekar et al., 2007). Some colleagues prefer to use a mini‐grafting test before a surgical intervention, although there has been discussion about its usefulness (Falabella et al., 1995).…”

Section: Koebner’s Phenomenon: Clinical Aspectsmentioning

confidence: 99%

Koebner’s phenomenon in vitiligo: European position paper

Geel

Speeckaert

Taı̈eb

et al. 2011

Pigment Cell Melanoma Res

101

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Summary Koebner’s phenomenon (KP) has been observed in a number of skin diseases, including vitiligo. Its clinical significance in vitiligo with respect to disease activity and course is still debatable, while its relevance for surgical techniques has been demonstrated in some reports. We present a literature review on the currently known facts about KP in vitiligo, including details of clinical, experimental, and histopathological changes. The consensus view is that there are still no methods to define and assess KP in vitiligo. A new classification is proposed to allow an evaluation of KP in daily practice or in experimental studies. However, many unanswered questions still remain after redefining KP in patients with vitiligo. Active research focusing on KP in vitiligo may not only provide unexpected clues in the pathogenesis of vitiligo but also help to tailor novel therapies against this chronic and often psychologically devastating skin disease.

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Section: Koebner’s Phenomenon: Clinical Aspectsmentioning

confidence: 99%

Koebner’s phenomenon in vitiligo: European position paper

Geel

Speeckaert

Taı̈eb

et al. 2011

Pigment Cell Melanoma Res

101

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“…6,[48][49][50][51] Repigmentation may lead to several shades of color in a particular lesion, 52 as may transitional stages in depigmentation (trichrome vitiligo). 64 A family history is present in up to 25% of cases; the inheritance appears to be polygenic. 55 Its first description dates back more than 3000 years.…”

Section: Disorders Of Pigmentation • Chapter 10mentioning

confidence: 99%

Disorders of pigmentation

Weedon

2010

Weedon's Skin Pathology

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“…Partial or complete failure to repigment following different surgical treatments and negative minigraft test has been reported despite clinical stability in the generalized as well as localized type of vitiligo patients [33][34][35][36]. Repigmentation of recipient areas in spite of koebnerization of donor site indicates that autoimmune activity may be different at different sites in the same patient [37].…”

Section: Factors To Be Considered For Surgical Therapies Stabilitymentioning

confidence: 99%

Surgical management of vitiligo

Mulekar¹

2010

Expert Review of Dermatology

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Vitiligo is a common condition characterized by hypopigmented and/or depigmented spots on the skin, affecting approximately 1-2% of the world population. Until approximately 30 years ago, it was exclusively treated by medical therapies. The most commonly used medical therapies include topical steroids, calcineurin inhibitors and phototherapy. Lesions on the face and neck respond the best to medical therapies, followed by lesions on the proximal extremities and trunk, while those distributed over acral parts of extremities and nonhairy areas, such as the wrist, feet and male genitals, respond poorly. Surgical methods complement medical therapies by providing melanocytes to these refractory lesions, and are indicated for unilateral segmental and clinically stable bilateral vitiligo, refractory to medical treatment. Tissue-grafting methods include minigrafting or punch grafting, epidermal grafting and split thickness grafting. These methods use full-thickness punch grafts, roof of epidermal blisters and shave biopsy samples, respectively, as the source of melanocytes. Cellular grafting includes noncultured and cultured melanocytes/keratinocytes suspensions obtained from trypsinizing the shaved skin biopsy sample as a source of melanocytes. Recent advances over the years have enabled dermatologists to treat extensive areas located on any anatomic site in a single operative session by surgical intervention. The purpose of this review is to describe the selection criteria for the surgical treatment, their utility and limitations in the various types of vitiligo.

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Koebner Phenomenon in Vitiligo: Not Always an Indication of Surgical Failure

Cited by 17 publications

References 3 publications

Koebner’s phenomenon in vitiligo: European position paper

Koebner’s phenomenon in vitiligo: European position paper

Disorders of pigmentation

Surgical management of vitiligo

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