Long term results of non cultured epidermal cellular grafting in vitiligo, halo nevi, piebaldism and nevus depigmentosus.

Br J Dermatol. 2010 Aug 28;

Authors: van Geel N, Wallaeys E, Goh BK, De Mil M, Lambert J

Abstract Background: Several surgical techniques are available for the treatment of stable leukoderma. The use of non cultured epidermal cellular grafting has been introduced in 1992. Data on long term follow-up regarding stability of the repigmented area, time to achieve the final repigmentation, color matching, reaction to sun exposure and patient's satisfaction of treatment are only reported a few times before. Objectives: To evaluate the long term results of the non cultured epidermal cellular grafting technique in patients with different types of leukoderma, including segmental vitiligo (33), generalized vitiligo (33), mixed vitiligo (6), halo nevi (11), piebaldism (3) and nevus depigmentosus (1). Methods: Patients were evaluated by examination and questionnaire in a retrospective setting after transplantation of autologous non cultured cellular grafting. Percentage of repigmentation was evaluated in 82 patients using a digital imaging analysis system (mean follow up 15 months). Long term results were evaluated by 54 patients using a questionnaire up to 7.7 years after treatment (mean 4 years). Results: More than 75% repigmentation was achieved in 70.7% of patients. Best results were obtained in segmental vitiligo, halo nevi and piebaldism, whereas results in generalized or mixed vitiligo were inferior. According to the patients, final repigmentation was achieved after a mean of 10 months post treatment. In 80.4% some color mismatch (hyper-and hypo-pigmentation) was reported between the treated area and the surrounding skin, although this was not disturbing for the majority. This color mismatch was reported significantly less after sun exposure (p= 0.012). During follow-up 6.7% of patients, all with generalized vitiligo, observed some loss of the achieved repigmentation. Conclusion: Autologous epidermal cellular grafting achieves a high percentage of repigmentation, which was maintained during follow-up in the majority of patients. Although it improves quality of life, in most patients a perfect color matching was seldom obtained.

PMID: 20804490 [PubMed - as supplied by publisher]