Modified Technique of Autologous Noncultured Epidermal Cell Transplantation for Repigmenting Vitiligo: A Pilot Study

Geel, Nanny van; Ongenae, Katia; Mil, Martine De; Naeyaert, Jean

doi:10.1046/j.1524-4725.2001.01045.x

Cited by 71 publications

(92 citation statements)

References 13 publications

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“…[26][27][28][29][30][31] The percentage repigmentation reported with cultured techniques ranges from 75-84% in patients with focal vitiligo/SV, to 30-54% in those with generalized vitiligo. 29,30 Noncultured cell transplantation, introduced as a 2-day procedure, 32 was modified by Olsson and Juhlin 33 as a day-care procedure with donor: recipient ratio of 1: 10. van Geel et al 34 added hyaluronic acid to increase the viscosity of the suspension, and Mulekar and colleagues 35,36 simplified the procedure by eliminating all supplements such as fibroblast growth factor and laminar flow bench and replacing carbon dioxide with an ordinary incubator. Repigmentation of at least 70% of the treated area was achieved in 77% of actively treated lesions at 12 months after treatment.…”

Section: Cultured and Noncultured Cellular Transplantation Methodsmentioning

confidence: 99%

Surgical interventions for vitiligo: an evidence-based review

Mulekar¹,

Isedeh

2013

Br J Dermatol

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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.

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Section: Cultured and Noncultured Cellular Transplantation Methodsmentioning

confidence: 99%

Surgical interventions for vitiligo: an evidence-based review

Mulekar¹,

Isedeh

2013

Br J Dermatol

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“…The epidermal cells thus obtained are suspended in either normal saline [62], M2 melanocyte medium (Promocell, Heidelberg, Germany) [63], Dulbecco-modified essential medium [64] or sodium lactate [65]. Addition of hyaluronic acid to the cell suspension improves the viscosity and attachment of cells to the recipient site [66]. The epidermis of achromic skin is superficially removed using diamond fraise wheel or Er:YAG laser.…”

Section: Noncultured Melanocyte-keratinocyte Transplantationmentioning

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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“…Results were slightly inferior to our previous findings in the actively treated lesions, but because of ethical, aesthetic, and scientific reasons the lesions in this study were often chosen at sites relatively difficult to treat, eg, at finger joints, ankles, and wrists. 8 As the posttreatment clinical course at the recipient site was only characterized by minimal signs of erythema and a temporary hyperpigmentation, the use of autologous epidermal cell suspensions may also be considered a safe therapeutic option in treating vitiligo.…”

Section: Commentmentioning

confidence: 99%

“…cellulargrafts. 8 Theviscosityofthecellulargaftwasincreased by addition of hyaluronic acid, a biodegradable cell carrier that improved adhesion of the graft to the dermabraded skin significantly. Using this method we obtained pigmentation in more than 80% of the treated area in the first 4 patients.…”

mentioning

confidence: 99%

“…Using this method we obtained pigmentation in more than 80% of the treated area in the first 4 patients. 8 However, there are still many uncertainties about the exact cellular mechanisms that lead to repigmentation using transplantation of autologous cells to abraded skin. In 1990 Knoell and associates 9 mentioned repigmentation of small dermabraded depigmented macules that had been exposed to PUVA therapy.…”

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confidence: 99%

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