Treatment of "Stable" Vitiligo by Timedsurgery and Transplantation of Cultured Epidermal Autografts

Guerra, Liliana; Capurro, Sebastián; Melchi, Francesco; Primavera, Grazia; Bondanza, Sergio; Cancedda, Ranieri; Luci, A.; Luca, Michele De; Pellegrini, Graziella

doi:10.1001/archderm.136.11.1380

Cited by 137 publications

(142 citation statements)

References 46 publications

(64 reference statements)

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“…Different modifications have been used to culture and transplant the cells in an attempt to enhance efficacy of the procedures. [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.…”

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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“…Keratinocytes cultured using this method, originally developed for epidermal keratinocytes [82], have been used: (a) since the 1980s on thousands of patients for the life-saving treatment of massive full-thickness burns (reviewed in [8]); (b) to restore pigmentation of stable vitiligo and piebaldism [83,84]; (c) to regenerate a functional urethral epithelium in patients with posterior hypospadias [39,85]; and (d) since the late 1990s for the restoration of the corneal surface on hundreds of patients with limbal stem cell deficiency (reviewed in [8]). During these nearly three decades, no adverse effect has been reported and this culture method has been approved by the Food and Drug Administration (FDA) in both the USA and Japan.…”

Section: The Culture Methods and The Preservation Of Functional Stem Cmentioning

confidence: 99%

Epithelial stem cells in corneal regeneration and epidermal gene therapy

Pellegrini

Rama²,

Mavilio

et al. 2008

The Journal of Pathology

100

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Regenerative medicine refers to innovative therapies aimed at the permanent restoration of diseased tissues and organs. Regeneration of self-renewing tissues requires specific adult stem cells, which need to be genetically modified to correct inherited genetic diseases. Cultures of epithelial stem cells permanently restore severe skin and mucosal defects, and genetically corrected epidermal stem cells regenerate a normal epidermis in patients carrying junctional epidermolysis bullosa. The keratinocyte stem cell is therefore the only cultured stem cell used both in cell therapy and gene therapy clinical protocols. Epithelial stem cell identification, fate and molecular phenotype have been extensively reviewed, but not in relation to tissue regeneration. In this paper we focus on the localization and molecular characterization of human limbal stem cells in relation to corneal regeneration, and the gene therapy of genetic skin diseases by means of genetically modified epidermal stem cells.

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“…They reported that cultured epidermal autografts sheets were better than pure melanocyte culture as presence of keratinocytes helps in regulating melanocyte growth and differentiation. 59,60 c) Noncultured Epidermal Cell suspension The melanocyte transplantation technique has now been modified to a one-time day care procedure in the form of transplantation of noncultured melanocyte-keratinocyte suspension. It is a simple technique in which cell culture is not needed and skin harvesting from the donor area, preparation of cell separation by trysinization and transplantation of melanocytes can all be undertaken in a single day procedure.…”

Section: A) Cultured Epidermal Autografts Containing Keratinocytes Anmentioning

confidence: 99%

Surgical management of vitiligo - An approach to the patient

Manchanda

Bansal

Pandey

2013

Nepal J Dermatol Venereol & Leprol

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Vitiligo vulgaris is an acquired chronic pigmentary disorder with an average world wide incidence of approximately 1%. Clinical classification of vitiligo is based on the distribution and extension of lesions as localized, generalized, and universal. As vitiligo has great psychosocial implications especially in dark-skinned individuals, treatment should begin early. Currrent modalities of treatment include medical therapy, surgical modalities and laser. Medical treatment options include topical corticosteroids, calcineurin inhibitors, vitamin-D derivatives, phototherapy (ultraviolet A [UVA], narrowband UVB), photochemotherapy (psoralen plus UVA [PUVA]. Surgical methods used in the management of vitiligo gave cosmetically acceptable results in short periods. Successful treatment with various surgical techniques requires an appropriate selection of patients mainly focusing upon the stability of the clinical disease. The choice of the procedure always depends upon the age, the area involved, site and the cosmetic need of the patient. The nature of the procedure, expected outcome and the complications should be discussed with the patient in detail. This article mainly deals with various dermatosurgical approaches in brief available till date for the treatment of vitiligo.

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Treatment of "Stable" Vitiligo by Timedsurgery and Transplantation of Cultured Epidermal Autografts

Cited by 137 publications

References 46 publications

Surgical interventions for vitiligo: an evidence-based review

Surgical interventions for vitiligo: an evidence-based review

Epithelial stem cells in corneal regeneration and epidermal gene therapy

Surgical management of vitiligo - An approach to the patient

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