Acral vitiligo and lesions over joints treated with non-cultured epidermal cell suspension transplantation

Abstract

Non-cultured epidermal cell suspension transplantation was successful in producing some degree of repigmentation in our patients, and could be a useful therapy for vitiligo lesions.

Autologous non-cultured melanocyte–keratinocyte transplantation in the treatment of vitiligo: patient selection and perspectives

“… 17 However, it was not clear in both studies if any of those lesions were over the fingertips (distal fingers). Holla et al 35 achieved >75% repigmentation in 78% of lesions over the dorsum of hands and feet and 42% of lesions over fingers and toes with only 6/80 lesions over acral skin showing <50% response (two over the ankle and four in distal fingers). Fingertips were found to show full repigmentation in one case in which cryoblebbing was used for recipient site preparation 29 raising the possibility that perhaps poor response was due to the difficulty in performing dermabrasion or laser resurfacing at this site.…”

“… 18 , 27 Inadequate depth of dermabrasion due to heavily cornified skin as well as the high mobility at these sites may explain the poor response. 46 Holla et al 35 used strict immobilization up to the extent of using plaster casts when needed and achieved >75% repigmentation in 21/33 (64%) treated lesions. In another study, a diamond fraise wheel at a high speed of 12,000–15,000 rpm was used to assure proper dermabrasion of the thick cornified skin with an excellent response achieved in 15/43 (35%) lesions over joints without applying strict immobilization.…”

“…However, harvesting of skin necessitates shaving part of the scalp which may be inconvenient to the patient; also, the procedure is a bit more difficult as the scalp is curved and more vascular. The gluteal region 3 , 4 , 8 , 9 or thigh 18 , 35 is usually chosen as the donor area in MKTP. We found no significant difference in melanocytic cell count between both sites (unpublished data, Bassiouny et al, 2017).…”

“…In another study, hyperpigmentation was more frequent over the joints which led the authors to suggest it may be due to frictional melanosis. 35 …”

Review of the 94th Annual Meeting of the British Association of Dermatologists, Glasgow 2014

“…Professor Kanwar reviewed the evidence for different treatments, including topical and oral steroids, oral minocycline, topical calcineurin inhibitors, phototherapy and surgery. [65][66][67] Three other presentations on the surgical treatment of vitiligo focused on potential improvement of noncultured epidermal suspension transplantation by the use of suspensions prepared from hair follicle outer root sheaths. [68][69][70] Although rare in the U.K., leprosy remains an important health problem in India.…”