Transverse Needling After Autologous Mini-Punch Grafts Improves Repigmentation in Stable Non-Segmental Vitiligo

Abstract

Background: Repigmentation remains the primary target in vitiligo treatment. Melanocyte transfer procedures are often required for repigmenting stable, resistant vitiligo lesions necessitating procedural optimization and comparative evaluation. In the current study, we aimed to assess the additive value of weekly transverse needling sessions after mini-punch grafting for repigmenting stable non-segmental vitiligo lesions versus either procedure alone. Methods: Eighty lesions, included in 20 stable non-segmental vitiligo patients, were randomly allocated to each of the three treatment groups (line-1, mini-punch grafting; line-2, needling; and line-3, combined grafting and needling) and to a fourth control group receiving non-procedural treatment (line-4). Oral mini-pulse steroids and narrow-band ultraviolet-B sessions were administered to all patients for 3 months before and 6 months after the interventions. The extent of repigmentation was assessed using planimetry. Secondary outcomes were the time to first repigmentation response, cosmetic matching, and patient satisfaction. Blinding and allocation concealment were not feasible owing to the intervention nature and within subject design. Results: Mini-punch grafting followed by weekly needling for 6 months achieved the fastest response and highest extent of repigmentation. Mini-punch grafts and transverse needling alone provided better results than the control group. No steroid-associated side effects were reported. Conclusion:Weekly needling sessions after mini-punch grafting hastened and improved the repigmentation extent of stable, resistant, non-segmental vitiligo lesions and should be considered during treatment planning.

Surgical Treatment of Vitiligo

“…Another interesting idea which, according to the authors, has a positive influence on the final therapeutic effects is the use of transverse needling after mini-punch grafting. The results of the treatment presented by the researchers suggest that this modification allows one to achieve a better degree of repigmentation in a shorter time and with the use of the lowest cumulative dose of NB-UVB compared to MPG and needling performed separately [25]. Notwithstanding the foregoing, according to the current guidelines published by the British Association of Dermatologists in 2021, there is insufficient evidence to allow a further recommendation of this method in the treatment of vitiligo [16].…”

Transplantation procedures in vitiligo: What's new

“…It was seen that the combination of the two resulted in the fastest and greatest extent of repigmentation, with a better color match. The postulated mechanism is stimulation and release of growth factors, along with mechanical delivery of melanocytes from the pigmented to the depigmented area 13 …”