Laser Ablation of the Recipient Area With Platelet-Rich Plasma–Enriched Epidermal Suspension Transplant in Vitiligo Surgery: A Pilot Study

Garg, Suruchi; Dosapaty, Namrata; Arora, Archana

doi:10.1097/dss.0000000000001641

Cited by 24 publications

(42 citation statements)

References 13 publications

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“…Specifically, six clinical studies regarding the use of PRP in vitiligo have been identified, with a total of 253 patients. 1,[12][13][14][15][16] The mean time of follow-up of treated patients was 6 months (ranging between 3 and 12 months). 1,[12][13][14][15][16] In all reports, 1,[12][13][14][15][16] all treated patients showed a stable vitiligo, and a significantly higher improvement in the PRP groups was always observed compared to control groups, regardless of the combined treatment associated with PRP.…”

Section: Resultsmentioning

confidence: 99%

“…1,[12][13][14][15][16] The mean time of follow-up of treated patients was 6 months (ranging between 3 and 12 months). 1,[12][13][14][15][16] In all reports, 1,[12][13][14][15][16] all treated patients showed a stable vitiligo, and a significantly higher improvement in the PRP groups was always observed compared to control groups, regardless of the combined treatment associated with PRP. 1,[12][13][14][15][16] Regarding the side effects, PRP in vitiligo patients is safe, without important and specific side effects.…”

Section: Resultsmentioning

confidence: 99%

“…1,[12][13][14][15][16] Regarding the side effects, PRP in vitiligo patients is safe, without important and specific side effects. 1,[12][13][14][15][16] Pain at the injection site was the main side effect, although it can be avoided applying 45-60 minutes before the injection of an anesthetic cream. 16 Besides, in order to avoid local superinfection, topical antibiotics can be used 3 days after injection.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

<p>The Usefulness of Platelet-Rich Plasma (PRP) for the Treatment of Vitiligo: State of the Art and Review</p>

Mercuri

Vollono

Paolino

2020

DDDT

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Introduction: Vitiligo is an acquired, idiopathic disorder clinically characterized by amelanotic lesions on the skin which cause significant impairment of patients' quality of life. A variety of treatments have been proposed, with inconsistent results. In the last decades, the use of platelet-rich plasma (PRP) is receiving increasing interest as a potential effective technique in the treatment of several dermatological diseases, including vitiligo. Objective: We conducted a review with the aim to identify studies that documented the use of PRP for vitiligo. Materials and Methods: Electronic databases of MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to November 2019 have been searched using different combinations of the following terms: "platelet-rich plasma", "platelet gel", "platelet-rich fibrin", "PRP" and "vitiligo". Results: We identified 6 clinical studies consistent with our research, with a total of 253 patients, listing and discussing the obtained results. In all reports, all treated patients showed a stable vitiligo, and a significantly higher improvement in the PRP groups was always observed compared to control groups. Regarding the side effects, PRP in vitiligo patients is useful and without important side effects. Conclusion: PRP is a promising treatment for stable vitiligo lesions in different body sites. The possible use of PRP in combination with traditional therapeutic options and the standardization of processing protocols represents a very fertile field for future research. Larger clinical trials with longer time of observation would provide solid evidence regarding the effectiveness of PRP for the treatment of vitiligo.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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<p>The Usefulness of Platelet-Rich Plasma (PRP) for the Treatment of Vitiligo: State of the Art and Review</p>

Mercuri

Vollono

Paolino

2020

DDDT

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“…Due to the progressive loss of functional melanocytes associated with an inflammatory/autoimmune context and the failure to spontaneously recover skin functionality, it has been proposed to consider vitiligo as a degenerative disease . In addition to pharmacological treatment, several different surgical and regenerative approaches have been proposed to restore pigmentation in vitiligo including dermabrasion, epidermal or hair follicle outer root sheath cell suspension transplant, cultured epithelial cells or cultured epithelia sheet graft, minipunch graf, suction blistering grafting, platelet‐rich plasma‐enriched (PRP) supplementation and the use of autologous mesenchymal stem cells (MSCs) . Repigmentation through dermis stimulation reflects the emerging key role of the dermal compartment in vitiligo since dermoabrasion and mechanical needling deeply stimulate the dermis and induce processes similar to a wound‐healing response with the release of different growth factors and inflammatory mediators .…”

Section: Introductionmentioning

confidence: 99%

“…In fact, clinical studies demonstrated that PRP injection significantly improves the clinical outcome when used in combination with fractional CO 2 laser treatment, or when associated with term NB‐UVB phototherapy, whereas PRP injection alone achieves unsatisfactory results . Similarly, a very recent study proposed the usage of PRP as supplementation of epidermal cell suspension, since graft‐based surgical methods to restore melanocyte abundance demonstrated mixed results in generating cosmetically acceptable repigmentation and need improvement. In particular, the preoperative care and postoperative care of the recipient site are crucial to obtain maximum adherence and to maintain survival of transplanted melanocytes.…”

Section: Introductionmentioning

confidence: 99%

Extracellular fraction of adipose tissue as an innovative regenerative approach for vitiligo treatment

Bellei

Papaccio

Filoni

et al. 2019

Experimental Dermatology

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Vitiligo is a common, disfiguring autoimmune disease that negatively affects patients’ self‐esteem and quality of life. Current treatments are moderately effective in reversing disease and promoting melanocyte regeneration. Thus, therapeutic advanced strategies are emerging from regenerative medicine. It has recently emerged that adipose tissue secretome may be used as a cell‐free therapy in skin regeneration since paracrine functions of adipose‐derived stem cells alone are responsible for most of the therapeutic effect of stem cells in several animal disease models. In this study, we tested the effect of adipose tissue extracellular fraction (AT‐Ex) isolated from lipoaspirates on dermal and epidermal vitiligo cells in vitro. Using this experimental model, we demonstrated that molecules secreted by adipose tissue ameliorate the capability to counteract oxidative stress by a physiological stimulation of intracellular antioxidant enzymes and positively impact on cell proliferation. Due to the presence of Wnt‐secreted factors, AT‐Ex treatment promotes glycogen synthase kinase 3β inactivation and consequently Wnt/β‐catenin pathway activation. Collectively, our findings show that AT‐Ex could be useful as a natural approach to improve treatment of vitiligo.

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Surgical Interventions for Patients With Vitiligo

Bae

Lee

et al. 2021

JAMA Dermatol

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IMPORTANCE Surgical interventions are a key part of the therapeutic arsenal, especially in refractory and stable vitiligo. Comparison of treatment outcomes between the different surgical procedures and their respective adverse effects has not been adequately studied.OBJECTIVE To investigate the reported treatment response following different surgical modalities in patients with vitiligo.DATA SOURCES A comprehensive search of the MEDLINE, Embase, Web of Science, and Cochrane Library databases from the date of database inception to April 18, 2020, was conducted. The key search terms used were vitiligo, surgery, autologous, transplantation, punch, suction blister, and graft.STUDY SELECTION Of 1365 studies initially identified, the full texts of 358 articles were assessed for eligibility. A total of 117 studies were identified in which punch grafting (n = 19), thin skin grafting (n = 10), suction blister grafting (n = 29), noncultured epidermal cell suspension (n = 45), follicular cell suspension (n = 9), and cultured epidermal cell suspension (n = 17) were used.DATA EXTRACTION AND SYNTHESIS Three reviewers independently extracted data on study design, patients, intervention characteristics, and outcomes. Random effects meta-analyses using generic inverse-variance weighting were performed. MAIN OUTCOMES AND MEASURESThe primary outcomes were the rates of greater than 90%, 75%, and 50% repigmentation response. These rates were calculated by dividing the number of participants in an individual study who showed the corresponding repigmentation by the total number of participants who completed the study. The secondary outcomes were the factors associated with treatment response to the surgical intervention. RESULTS Among the 117 unique studies and 8776 unique patients included in the analysis, rate of repigmentation of greater than 90% for surgical interventions was 52.69% (95% CI, 46.87%-58.50%) and 45.76% (95% CI, 30.67%-60.85%) for punch grafting, 72.08% (95% CI, 54.26%-89.89%) for thin skin grafting, 61.68% (95% CI, 47.44%-75.92%) for suction blister grafting, 47.51% (95% CI, 37.00%-58.03%) for noncultured epidermal cell suspension, 36.24% (95% CI, 18.92%-53.57%) for noncultured follicular cell suspension, and 56.82% (95% CI, 48.93%-64.71%) for cultured epidermal cell suspension. The rate of repigmentation of greater than 50% after any surgical intervention was 81.01% (95% CI, 78.18%-83.84%). In meta-regression analyses, the treatment response was associated with patient age (estimated slope, −1.1418), subtype of vitiligo (estimated slope, 0.3047), and anatomical sites (estimated slope, −0.4050). CONCLUSIONS AND RELEVANCEThe findings of this systematic review and meta-analysis suggest that surgical intervention can be an effective option for refractory stable vitiligo. An appropriate procedure should be recommended based on patient age, site and size of the lesion, and costs.

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Laser Ablation of the Recipient Area With Platelet-Rich Plasma–Enriched Epidermal Suspension Transplant in Vitiligo Surgery: A Pilot Study

Cited by 24 publications

References 13 publications

<p>The Usefulness of Platelet-Rich Plasma (PRP) for the Treatment of Vitiligo: State of the Art and Review</p>

<p>The Usefulness of Platelet-Rich Plasma (PRP) for the Treatment of Vitiligo: State of the Art and Review</p>

Extracellular fraction of adipose tissue as an innovative regenerative approach for vitiligo treatment

Surgical Interventions for Patients With Vitiligo

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