Use of platelet‐rich plasma to suspend noncultured epidermal cell suspension improves repigmentation after autologous transplantation in stable vitiligo: a double‐blind randomized controlled trial

Abstract

Background Noncultured epidermal cell suspension (NCES) is an effective surgical modality for stable vitiligo which involves transplantation of the basal layer of epidermal cells onto the dermabraded vitiliginous patch. Platelet-rich plasma (PRP) has growth factors which may stimulate melanocyte migration and proliferation of keratinocytes and fibroblasts. The objective of this study was to compare the extent of repigmentation achieved by transplantation of NCES suspended in PRP with that of NCES suspended in phosphate buffered saline (PBS).Methods Twenty-one patients of stable vitiligo with at least two lesions of comparable size were included. The two vitiligo patches were randomized to receive NCES suspended in PRP or PBS. Postoperatively after 1 week, patients were given heliotherapy for 15 minutes daily.Results At 6 months follow-up, mean repigmentation by area method in PRP arm was 75.6 AE 30% SD and in non-PRP arm was 65 AE 34% SD (P = 0.0036). Patient satisfaction by visual analogue scale at 6 months also showed better results in PRP arm (P = 0.001).Assessment by three independent observers showed better repigmentation in PRP side both at 3 and 6 months.Conclusions Suspending NCES in PRP can result in significantly greater mean repigmentation and patient satisfaction than suspending in PBS.

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

“…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.…”

“…Vitiligo is an acquired, idiopathic disorder clinically characterized by amelanotic lesions on the skin, due to destruction and subsequent absence of melanocytes. 1 The prevalence of vitiligo is between 0.4% and 4%, with a positive familiar history in about 30% of cases. 2,3 Although vitiligo is not a life-threatening disorder, about 1/3 of patients with vitiligo suffers from psychological disorders, with significant impairment of quality of life.…”

“…4 While surgery techniques are mainly based on autologous transplanting of melanocytes. 1,5 However, despite the presence of several therapeutic options, all these therapeutic modalities show limited responses. 3…”

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

“…Based on the results presented in this study, this procedure may be improved in the future by the replacement of plasma with AT‐Ex. Similarly, autologous PRP has been proposed to improve epidermal cell suspension transplantation in vitiligo patients . Due to the extremely high concentration of growth factors, PRP is considered to be a growth factor “storm” necessary for tissue rebuilding after injury.…”

“…Similarly, autologous PRP has been proposed to improve epidermal cell suspension transplantation in vitiligo patients. [72] Due to the extremely high concentration of growth factors, PRP is considered to be a growth factor "storm" necessary for tissue rebuilding after injury. However, this is not necessarily the same situation for vitiligo lesional skin.…”