Punch Grafting versus Suction Blister Epidermal Grafting in the Treatment of Stable Lip Vitiligo

Abstract

BACKGROUND Among surgical methods, punch skin grafting (PSG) and suction blister epidermal grafting (SBEG) are simple, inexpensive, and effective treatment methods for resistant lip vitiligo cases, but there is a lack of comparison between these procedures for lip vitiligo. OBJECTIVE The objective was to compare the outcome following PSG and SBEG in stable lip vitiligo. METHODS Eighteen patients with stable lip vitiligo were randomly selected. Eight patients were included in PSG group and 10 patients in SBEG. All patients were kept on PUVA‐SOL (psoralen+ultraviolet A therapy of solar origin) treatment after grafting. The results were evaluated after a follow‐up period of 6 months. RESULTS At the end of 6 months of grafting in PSG group, two patients had a repigmentation of 50% to 75%, one had 75% to 90%, and three had 90% to 100% in the recipient site in lip. In SBEG group, one patient had repigmentation of 50% to 75%, three had 75% to 90%, and two had 90% to 100%. The color match was statistically significant in PSG when compared to SBEG. In the recipient site, cobblestone appearance was the predominant complication in PSG whereas hyperpigmentation and thickening of grafts were common in SBEG. In the donor site, superficial scarring and hypopigmentation were the common findings in PSG group whereas hyperpigmentation was the main problem in SBEG group. CONCLUSIONS Although both the procedures are effective in lip vitiligo, PSG gives a better color match than SBEG.

Surgical interventions for vitiligo: an evidence-based review

“…Punch graft vs. blister roof grafts. These two techniques were compared in a study by Babu et al 25 Eighteen patients with stable lip vitiligo were randomly selected. Eight patients were in the PG group and 10 patients in the BG group.…”

Ultrathin split-thickness skin grafting followed by narrowband UVB therapy for stable vitiligo: An effective and cosmetically satisfying treatment option

“…[13] Miniature punch grafting is the simplest procedure to perform, but it is commonly associated with adverse effects like "cobble-stoning" and "polka-dot" appearance at the recipient site as well as some residual scarring at the donor site. [19] Suction blister grafting is associated with an excellent cosmetic and color matching at the recipient site and it does not normally cause any scarring at the donor site as well, but the procedure is time consuming and can take care of only smaller areas of depigmentation in a single sitting. [20] Split-thickness skin grafting is another tissuegrafting procedure used in vitiligo which provides a good, cosmetically acceptable repigmentation at the recipient site and does not lead to significant scarring at the donor site as well.…”

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

“…Each method has its pros and cons. The mini-graft is simple and non-expensive, but it has the highest rate of adverse effects, with a 35% risk of cobblestone appearance at the recipient site and hypopigmentation and keloid formation at the donor site [34,35]. Thin split-thickness grafting has the highest mean success rate (87%) according to a systematic review by Njoo et al [27] Transplantation of melanocytes cultured in vitro from a small piece of donor skin is very expensive and requires special and advanced laboratory facilities that are currently available only at a few academic centers [9].…”