Pathogenesis of vitiligo is believed to be multifactorial disease with a wide variety of therapeutic modalities. The aim of this work is to assess the efficacy of oral mini-pulse steroids (OMP) plus Nb-U.V.B in comparison to OMP alone and Nb-U.V.B alone in treating stable vitiligo. A prospective randomized controlled study including 45 patients categorized into three groups receiving therapy for 3 months; Group A received Nb-U.V.B plus OMP, Group B received OMP alone while Group C received Nb-U.V.B alone. Clinical assessment and PCR evaluation of bFGF, ICAM1, and ELISA for AMA were done. Patients receiving Nb-U.V.B plus OMP and using Nb-U.V.B alone gave statistically significant clinical response than those treated with OMP alone. Statistically significant rise of BFGF was noticed after treatment with Nb-U.V.B plus OMP and with Nb-U.V.B alone. Patients treated with OMP alone and with Nb-U.V.B alone showed statistically significant drop of ICAM-1 after therapy. NB-U.V.B plus OMP and Nb-U.V.B alone were found to be clinically superior over OMP alone in treating stable vitiligo patients, hence suggesting that adding OMP to Nb-U.V.B can maintain clinical and laboratory success for a longer period of time and with less relapse.

Correction of depigmentation of postburn leukodermic scars is daunting. In contrast to vitiligo, the success rate of skin grafting techniques is much lower in postburn scars owing to altered skin architecture and poor graft uptake. Cellular transfer techniques such as noncultured epidermal or epidermal or keratinocyte suspension suffer the limitations of modest efficacy and high procedural cost. Follicular transplantation by the follicular unit extraction technique is being extensively used in vitiligo. Recently, it has been reported for the correction of scar alopecia. Although this approach is expected to significantly repigment pliant scars, the cosmetic unacceptability of the retained hairs may warrant removal. We describe an innovative three-step protocol to provide a repigmented smooth scar. We vernacularly labeled this technique follicular unit “exploitation,” as the follicular units “exploited” positively for repigmentation were later removed by laser hair reduction.

No abstract