Epithelial grafting for vitiligo requires ultraviolet A phototherapy to increase success rate

Awad, Sherif Shoukry; Abdel-Raof, Hamza; El‐Din, Wael Hosam; El‐Domyati, Moetaz

doi:10.1111/j.1473-2165.2007.00307.x

Cited by 31 publications

(36 citation statements)

References 24 publications

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“…usually after 1 week) phototherapy was used to induce proliferation and migration of melanocytes in the recipient sites. (29)(30)(31) The repigmentation rate in these studies according to the review by Njoo et al was 87%, whereas Ozdemi et al reported rates between 25% -65%. (29)(30)(31)(32)(33)(34)(35)(36) In the study by Maleki et al, ten patients with refractory vitiligo who were treated by suction blister graft and subsequent PUVA therapy reported over 90% repigmentation in seven patients.…”

Section: Discussionmentioning

confidence: 90%

Suction Blister Grafting- Still a Useful Modality for Treatment of Resistant and Stable Vitiligo

S¹,

Chittoory²

2017

jemds

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BACKGROUNDVitiligo is a common depigmentation disorder due to absence of functional melanocytes in the affected area. Depending on the type, extent and duration of vitiligo, conventional medical therapies and phototherapy are used. Medical treatment is effective in only 60% -70% of the patients. This has led to the evolution of various surgical modalities to treat recalcitrant stable lesions. The aim of this study was to determine the efficacy of suction blister grafts for treatment of recalcitrant and stable vitiligo. MATERIALS AND METHODSThis study was conducted on 20 patients with stable vitiligo. They included lip vitiligo (6 cases), segmental vitiligo (6 cases) and focal vitiligo (8) that were resistant to conventional medical treatments. Manual suction with 20 cc disposable syringes for blisters at donor site and dermabrasion at recipient site was done. The blister was separated, fixed at recipient site and dressing was done followed by NBUVB thrice a week for 3 months. Repigmentation of lesions was evaluated monthly for 6 months after treatment. Repigmentation rates > 90%, 71% -90%, 51% -70% and < 50% were graded as complete, good, moderate and poor respectively. RESULTSThis study includes 20 patients (10 female and 10 male) with stable vitiligo were evaluated for response following suction blister grafting with thrice weekly post-graft phototherapy. Reponses to treatment after a 6-month followup were 'complete,' 'good' and 'moderate' in 12 (60%), 6 (30%) and 2 (10%) patients respectively and one patient was lost for followup. CONCLUSIONThe grafting procedures in vitiligo are performed for cosmetic purposes. Proper selection of the patient is the most important factor for achieving a good cosmetic result. Stability of the disease process is the most important parameter to achieve a successful outcome. Suction blister grafting gives excellent cosmetic results with minimal chances of scarring at the donor or recipient sites.

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Section: Discussionmentioning

confidence: 90%

Suction Blister Grafting- Still a Useful Modality for Treatment of Resistant and Stable Vitiligo

S¹,

Chittoory²

2017

jemds

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“…Therefore, this procedure is actually ''melanocyte transfer'' and the epidermis obtained through suction blisters is only a carrier [36,37]. In most studies in the literature, 1 week after the surgical procedure phototherapy was used to induce proliferation of melanocytes at the recipient sites [38][39][40]. However, in two studies the authors proved that it is not necessary for obtaining repigmentation in vitiligous areas [41,42].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of suction blister epidermal grafting with concomitant phototherapy in vitiligo treatment

Iwanowski

Szlązak

Rustowska

et al. 2018

pdia

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A b s t r a c tIntroduction: There are many surgical methods for vitiligo treatment that have been used for over 30 years. Suction blister epidermal grafting (SBEG) is considered one of the simplest and most effective of them. Aim: To determine how effective suction blister grafts with concomitant phototherapy are in vitiligo treatment. Material and methods: The study was conducted on 10 patients with vitiligo that was resistant to previous treatment including phototherapy in monotherapy. Involvement of affected sites was different for every patient. We used cryotherapy for blistering at the recipient site and an automatic suction device for blistering at the donor site. The blister was separated from the donor site and fixed with dressing to the recipient site. After removing the final dressing (about 7 days after SBEG) patients started phototherapy (6 patients had UVB 311 nm and 4 had PUVA). All patients treated with UVB 311 nm were qualified for treatment in our clinic and the method was chosen according to expert recommendations from the European Dermatology Forum (EDF) Guidelines for Vitiligo where narrowband (NB) UVB is the phototherapy of choice. Three patients who had PUVA therapy were treated with this method in other clinical centers and sent to us only to undergo SBEG. One patient had previously received UVB 311 nm for 3 months, which showed no effects. Repigmentation of lesions was evaluated at 3 and 6 months after the surgical procedure. Results: Ten patients (9 females with a mean age of 36.88 years and 1 man aged 39 years) were enrolled in the study. Nine patients showed progressive repigmentation at 3 and 6 months follow-up with a rate varying from 13 to 76% (mean: 44.5%) and 35 to 100% (mean: 67.5%). One patient showed 5% depigmentation at a visit after 6 months in comparison to the follow-up visit 3 months after SBEG. Conclusions: With this technique, patients who did not respond to the usual treatments showed very good repigmentation over a 6-month follow-up. There were no side effects such as scarring.

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“…Previous studies have reported that the combination of epithelial grafting and psoralen plus UVA may speed up repigmentation, [11][12][13] with some starting phototherapy as early as immediately postgrafting. The most recent European Dermatology Forum consensus guidelines on vitiligo recommended that when a surgical treatment is conducted in nonsegmental vitiligo, it should be combined with UV light treatment for best outcome and long-term stability.…”

Section: In 2005mentioning

confidence: 99%

Twelve-month and sixty-month outcomes of noncultured cellular grafting for vitiligo

Gan

Kong

Tan

et al. 2016

Journal of the American Academy of Dermatology

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Epithelial grafting for vitiligo requires ultraviolet A phototherapy to increase success rate

Abstract: The success of epithelial grafting in patients with vitiligo can be increased by UVA phototherapy.

Cited by 31 publications

References 24 publications

Suction Blister Grafting- Still a Useful Modality for Treatment of Resistant and Stable Vitiligo

Suction Blister Grafting- Still a Useful Modality for Treatment of Resistant and Stable Vitiligo

Efficacy of suction blister epidermal grafting with concomitant phototherapy in vitiligo treatment

Twelve-month and sixty-month outcomes of noncultured cellular grafting for vitiligo

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