Abstract
Vitiligo is a chronic autoimmune disorder of the skin in which melanocytes are destroyed resulting in patchy areas of skin depigmentation. This disease occurs in approximately 1% of the world’s population without predilection for sex, race, or ethnicity (5) (Ezzedine et al., Lancet 386:74e84, 2015). Vitiligo can be classified into three major categories: segmental vitiligo , which has a unilateral distribution, non-segmental or generalized vitiligo , and mixed vitiligo , which is a combination of the former two (Ezzedine et al., Lancet 386:74e84, 2015). Approximately half of those affected with vitiligo develop their first lesion before the age of 20 (Ezzedine et al., Lancet 386:74e84, 2015). Vitiligo can be disfiguring, especially in dark-skinned individuals, and can have a significant psychological and social impact with major consequences on the quality of life for those affected (4) (Kostopoulou et al., Br J Dermatol 161:128–133, 2009). Other autoimmune disorders, including thyroid disease, pernicious anemia, Addison’s disease, systemic lupus erythematosus, and alopecia areata, have been associated with vitiligo (2c) (Alkhateeb et al., Pigment Cell Res 16(3):208–214, 2003).
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References
Ezzedine K, Eleftheriadou V, Whitton M, et al. Vitiligo. Lancet. 2015;386:74e84.
Kostopoulou P, Jouary T, Quintard B, et al. Objective vs. subjective factors in the psychological impact of vitiligo: the experience from a French referral centre. Br J Dermatol. 2009;161:128–33.
Alkhateeb A, Fain PR, Thody A, Bennett DC, Spritz RA. Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Res. 2003;16(3):208–14.
Whitton M, Pinart M, Batchelor JM, Leonardi-Bee J, Gonzalez U, Jiyad Z, Eleftheriadou V, Ezzedine K. Evidence-based management of vitiligo: summary of a Cochrane systematic review. Br J Dermatol. 2016;174(5):962–9.
Falabella R. Surgical approaches for stable vitiligo. Dermatol Surg. 2005;31(10):1277–84.
Ezzedine K, Lim HW, Suzuki T, Katayama I, Hamzavi I, Lan CC, Goh BK, Anbar T, Silva de Castro C, Lee AY, Parsad D. Revised classification/nomenclature of vitiligo and related issues: the Vitiligo Global Issues Consensus Conference. Pigment Cell Melanoma Res. 2012;25(3):E1–3.
Taieb A, Alomar A, Böhm M, Dell’Anna ML, De Pase A, Eleftheriadou V, Ezzedine K, Gauthier Y, Gawkrodger DJ, Jouary T, Leone G. Guidelines for the management of vitiligo: the European Dermatology Forum consensus. Br J Dermatol. 2013;168(1):5–19.
Falabella R. Epidermal grafting: an original technique and its application in achromic and granulating areas. Arch Dermatol. 1971;104(6):592–600.
Kiistala U, Mustakallio KK. Dermo-epidermal separation with suction: electron microscopic and histochemical study of initial events of blistering on human skin. J Investig Dermatol. 1967;48(5):466–77.
Peachey RD. Skin temperature and blood flow in relation to the speed of suction blister formation. Br J Dermatol. 1971;84(5):447–52.
Laxmisha C, Babu A, Thappa DM. Infrared lamps for faster suction blister induction. Dermatol Surg. 2006;32(8):1111–2.
Al-Hadidi N, Griffith JL, Al-Jamal MS, Hamzavi I. Role of recipient-site preparation techniques and post-operative wound dressing in the surgical management of vitiligo. J Cutan Aesthet Surg. 2015;8(2):79.
Gupta S, Kumar B. Epidermal grafting in vitiligo: influence of age, site of lesion, and type of disease on outcome. J Am Acad Dermatol. 2003;49(1):99–104.
Njoo MD, Westerhof W, Bos JD, Bossuyt PM. A systematic review of autologous transplantation methods in vitiligo. Arch Dermatol. 1998;134(12):1543–9.
Li J, Fu WW, Zheng ZZ, Zhang QQ, Xu Y, Fang L. Suction blister epidermal grafting using a modified suction method in the treatment of stable vitiligo: a retrospective study. Dermatol Surg. 2011;37(7):999–1006.
Gou D, Currimbhoy S, Pandya AG. Suction blister grafting for vitiligo: efficacy and clinical predictive factors. Dermatol Surg. 2015;41(5):633–9.
Fongers A, Wolkerstorfer A, Nieuweboer-Krobotova L, Krawczyk P, Tóth GG, Van Der Veen JP. Long-term results of 2-mm punch grafting in patients with vitiligo vulgaris and segmental vitiligo: effect of disease activity. Br J Dermatol. 2009;161(5):1105–11.
Lahiri K, Malakar S, Sarma N, Banerjee U. Repigmentation of vitiligo with punch grafting and narrow-band UV-B (311 nm)–a prospective study. Int J Dermatol. 2006;45(6):649–55.
Malakar S, Dhar S. Treatment of stable and recalcitrant vitiligo by autologous miniature punch grafting: a prospective study of 1,000 patients. Dermatology. 1999;198(2):133–9.
Kato H, Furuhashi T, Ito E, Kaneko N, Nakamura M, Watanabe S, Shintani Y, Maeda A, Yamaguchi Y, Morita A. Efficacy of 1-mm minigrafts in treating vitiligo depends on patient age, disease site and vitiligo subtype. J Dermatol. 2011;38(12):1140–5.
Lahiri K, Sengupta SR. A regionwise comparative study of post punch graft appearance of repigmentation (AOR) time in cutaneous achromia. Indian J Dermatol. 1998;43(01):13.
Linthorst-Homan MW, Spuls PI, Nieuweboer-Krobotova L, de Korte J, Sprangers MA, Bos JD, Wolkerstorfer A, van der Veen JP. A randomized comparison of excimer laser versus narrow-band ultraviolet B phototherapy after punch grafting in stable vitiligo patients. J Eur Acad Dermatol Venereol. 2012;26(6):690–5.
Feetham JH, Chan JL, Pandya AG. Characterization of clinical response in patients with vitiligo undergoing autologous epidermal punch grafting. Dermatol Surg. 2012;38(1):14–9.
Mapar MA, Safarpour M, Mapar M, Haghighizadeh MH. A comparative study of the mini-punch grafting and hair follicle transplantation in the treatment of refractory and stable vitiligo. J Am Acad Dermatol. 2014 30;70(4):743–7.
Al-Mutairi NA, Manchanda Y, Al-Doukhi AZ, Al-Haddad AH. Long-term results of Split-skin grafting in combination with excimer laser for stable vitiligo. Dermatol Surg. 2010;36(4):499–505.
Agrawal K, Agrawal A. Vitiligo: repigmentation with dermabrasion and thin Split-thickness skin graft. Dermatol Surg. 1995 1;21(4):295–300.
Mulekar SV, Isedeh P. Surgical interventions for vitiligo: an evidence-based review. Br J Dermatol. 2013;169(s3):57–66.
Guerra L, Capurro S, Melchi F, Primavera G, Bondanza S, Cancedda R, Luci A, De Luca M, Pellegrini G. Treatment of stable vitiligo by Timedsurgery and transplantation of cultured epidermal autografts. Arch Dermatol. 2000;136(11):1380–9.
Chen YF, Yang PY, Hu DN, Kuo FS, Hung CS, Hung CM. Treatment of vitiligo by transplantation of cultured pure melanocyte suspension: analysis of 120 cases. J Am Acad Dermatol. 2004;51(1):68–74.
Pandya V, Parmar KS, Shah BJ, Bilimoria FE. A study of autologous melanocyte transfer in treatment of stable vitiligo. Indian J Dermatol Venereol Leprol. 2005;71(6):393.
Hong WS, Hu DN, Qian GP, McCormick SA, Xu AE. Treatment of vitiligo in children and adolescents by autologous cultured pure melanocytes transplantation with comparison of efficacy to results in adults. J Eur Acad Dermatol Venereol. 2011;25(5):538–43.
Guerra L, Primavera G, Raskovic D, Pellegrini G, Golisano O, Bondanza S, Paterna P, Sonego G, Gobello T, Atzori F, Piazza P. Erbium: YAG laser and cultured epidermis in the surgical therapy of stable vitiligo. Arch Dermatol. 2003;139(10):1303–10.
Gauthier Y, Surleve-Bazeille JE. Autologous grafting with noncultured melanocytes: a simplified method for treatment of depigmented lesions. J Am Acad Dermatol. 1992;26(2):191–4.
Olsson MJ, Juhlin L. Leucoderma treated by transplantation of a basal cell layer enriched suspension. Br J Dermatol. 1998;138(4):644–8.
van Geel N, Ongenae K, De Mil M, Naeyaert JM. Modified technique of autologous noncultured epidermal cell transplantation for repigmenting vitiligo: a pilot study. Dermatol Surg. 2001;27(10):873–6.
van Geel N, Goh BK, Wallaeys E, De Keyser S, Lambert J. A review of non-cultured epidermal cellular grafting in vitiligo. J Cutan Aesthet Surg. 2011;4(1):17.
Jeong HS, Vandergriff T, Pandya AG. Use of suction blisters for noncultured epidermal suspension grafting in patients with vitiligo. Dermatol Surg. 2016;42(5):688–91.
van Geel N, Ongenae K, De Mil M, Vander Haeghen Y, Vervaet C, Naeyaert JM. Double-blind placebo-controlled study of autologous transplanted epidermal cell suspensions for repigmenting vitiligo. Arch Dermatol 2004;140(10):1203–08.
Silpa-archa N, Griffith JL, Williams MS, Lim HW, Hamzavi IH. Prospective comparison of recipient-site preparation with fractional carbon dioxide laser vs. dermabrasion and recipient-site dressing composition in melanocyte–keratinocyte transplantation procedure in vitiligo: a preliminary study. Br J Dermatol. 2016;174:895.
Mulekar SV. Long-term follow-up study of segmental and focal vitiligo treated by autologous, noncultured melanocyte-keratinocyte cell transplantation. Arch Dermatol. 2004;140(10):1211–5.
van Geel N, Wallaeys E, Goh BK, De Mil MA, Lambert J. Long-term results of noncultured epidermal cellular grafting in vitiligo, halo naevi, piebaldism and naevus depigmentosus. Br J Dermatol. 2010;163(6):1186–93.
Mulekar SV. Melanocyte-keratinocyte transplantation procedure: a few insights. Indian J Dermatol Venereol Leprol. 2016;82(1):13.
Mulekar SV, Al Eisa A, Delvi MB, Al Issa A, Al Saeed AH. Childhood vitiligo: a long-term study of localized vitiligo treated by noncultured cellular grafting. Pediatr Dermatol. 2010;27(2):132–6.
Huggins RH, Henderson MD, Mulekar SV, Ozog DM, Kerr HA, Jabobsen G, Lim HW, Hamzavi IH. Melanocyte-keratinocyte transplantation procedure in the treatment of vitiligo: the experience of an academic medical center in the United States. J Am Acad Dermatol. 2012;66(5):785–93.
Ebadi A, Rad MM, Nazari S, Fesharaki RJ, Ghalamkarpour F, Younespour S. The additive effect of excimer laser on non-cultured melanocyte–keratinocyte transplantation for the treatment of vitiligo: a clinical trial in an Iranian population. J Eur Acad Dermatol Venereol. 2015;29(4):745–51.
Finlay AY, Khan G. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210–6.
Budania A, Parsad D, Kanwar AJ, Dogra S. Comparison between autologous noncultured epidermal cell suspension and suction blister epidermal grafting in stable vitiligo: a randomized study. Br J Dermatol. 2012;167(6):1295–301.
Czajkowski R. Comparison of melanocytes transplantation methods for the treatment of vitiligo. Dermatol Surg. 2004;30(11):1400–5.
Gupta S, Jain VK, Saraswat PK, Gupta S. Suction blister epidermal grafting versus punch skin grafting in recalcitrant and stable vitiligo. Dermatol Surg. 1999;25(12):955–8.
Babu A, Thappa DM, Jaisankar TJ. Punch grafting versus suction blister epidermal grafting in the treatment of stable lip vitiligo. Dermatol Surg. 2008;34(2):166–78.
Verma G, Varkhande SR, Kar HK, Rani R. Evaluation of repigmentation with cultured melanocyte transplantation (CMT) compared with non-cultured epidermal cell transplantation in vitiligo at 12th week reveals better repigmentation with CMT. J Invest Dermatol. 2015;135(10):2533.
Olsson MJ, Juhlin L. Long-term follow-up of leucoderma patients treated with transplants of autologous cultured melanocytes, ultrathin epidermal sheets and basal cell layer suspension. Br J Dermatol. 2002;147(5):893–904.
Khunger N, Kathuria SD, Ramesh V. Tissue grafts in vitiligo surgery-past, present, and future. Indian J Dermatol. 2009;54(2):150.
Falabella R, Arrunategui A, Barona MI, Alzate A. The minigrafting test for vitiligo: detection of stable lesions for melanocyte transplantation. J Am Acad Dermatol. 1995;32(2):228–32.
Njoo MD, Das PK, Bos JD, Westerhof W. Association of the Koebner phenomenon with disease activity and therapeutic responsiveness in vitiligo vulgaris. Arch Dermatol. 1999;135(4):407–13.
Parsad D, Gupta S. Standard guidelines of care for vitiligo surgery. Indian J Dermatol Venereol Leprol. 2008;74(7):37.
Ko WC, Chen YF. Suction blister epidermal grafts combined with CO2 laser superficial ablation as a good method for treating small-sized vitiligo. Dermatol Surg. 2009;35(4):601–6.
Gupta S, Kumar B. Epidermal grafting for vitiligo in adolescents. Pediatr Dermatol. 2002;19(2):159–62.
Kovacs D, Abdel-Raouf H, Al-Khayyat M, Abdel-Azeem E, Hanna MR, Cota C, Picardo M, Anbar TS. Vitiligo: characterization of melanocytes in repigmented skin after punch grafting. J Eur Acad Dermatol Venereol. 2015;29(3):581–90.
Czajkowski R, Pokrywczynska M, Placek W, Zegarska B, Tadrowski T, Drewa T. Transplantation of cultured autologous melanocytes: hope or danger? Cell Transplant. 2010;19(5):639–43.
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Hinojosa, J.A., Tovar-Garza, A., Pandya, A.G. (2019). Vitiligo. In: Alam, M. (eds) Evidence-Based Procedural Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-030-02023-1_55
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DOI: https://doi.org/10.1007/978-3-030-02023-1_55
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