Satellite repigmentation after punch grafting

Abstract

Punch grafting is an established treatment modality for management of localized, nonprogressive vitiligo resistant to conventional therapies.(1) In our set up, punch grafting is routinely carried out in focal vitiligo, segmental vitiligo and even in few cases of generalized vitiligo, especially when it is a serious cosmetic problem.(2) However, the procedure is adopted only when the disease is stable for a sufficient period. All patients are routinely kept on psoralen tablets and ultraviolet light exposure from sunlight (PUVA sol therapy) after 2-3 weeks of punch grafting. Interestingly, follow up of such patients revealed conspicuous repigmentation in surrounding ungrafted patches in four of the patients (out of 55 follow-up cases). Herein, this phenomenon has been aptly termed satellite repigmentation (SR). To the best of our knowledge, no other report documenting SR after punch grafting exists in the medical literature. We report the observations of these four patients.

Disorders of pigmentation

“…If less than 10% of the BSA is involved various treatments can be used including topical corticosteroids, topical calcineurin inhibitors, phototherapy, and transplantation with autologous melanocytes or epidermal cell suspensions (see below). 199,[209][210][211][212][213][214] If more than 80% of the BSA is involved, consideration should be given to depigmenting the normal skin with a hydroquinone cream or a combination of the cream with Q-switched ruby laser therapy. [205][206][207][208] Some success has been achieved in generalized vitiligo with autologous minigrafting.…”

Dirofilaria repens: A dog parasite presenting as a paranasal subcutaneous nodule

“…The rate and extent of this spontaneous repigmentation were noted and compared with the grafted sites. 3 This theory is essentially no different from ours. 2 Another theory was that the immunogenic mechanism, which was originally responsible for the development of vitiligo, may have lost its antigenicity due to the autologous grafts.…”

“…2 Another theory was that the immunogenic mechanism, which was originally responsible for the development of vitiligo, may have lost its antigenicity due to the autologous grafts. 3 Over the years, we have carried out several studies on punch grafting in vitiligo and have documented the largest study to date. Here, the author proposed a role for growth factor from donor keratinocytes, which stimulated melanocytes to proliferate and migrate into vitiliginous patches or diffuse into the surrounding vitiliginous patch and stimulate the viable but dormant melanocytes present.…”

Repigmentation of vitiligo with punch grafting and narrow‐band UV‐B (311 nm) – a prospective study

“…This has been documented previously, and a remote reverse Koebner's phenomenon has been suggested as the mechanism responsible 45 . Recently, more reports of such observations have been documented 46 …”