Who may be considered for surgical treatment of vitiligo?
Surgical treatment options can be considered in patients with stable vitiligo who fail to respond to medical therapy and phototherapy.
What types of surgical treatments for vitiligo are available?
The aim of all surgical treatments is to transfer melanocytes (pigment-producing cells) from normal skin (the donor site) to the skin affected by vitiligo (recipient site)
There are two main approaches to surgical treatment of vitiligo:
- Tissue grafting involves grafting of tissue that is melanocyte rich (not affected by vitiligo) to the vitiligo-affected site. Various techniques have been employed including miniature punch grafting, suction blister grafting and split thickness skin grafting
- Cellular grafting is a newer and more effective technique that involves grafting a specially prepared liquid suspension of one’s own skin cells. This technique is called autologous non-cultured melanocyte-keratinocyte transplantation.
Autologous non-cultured melanocyte keratinocyte transplantation
Utilising this technique, tissue is grafted (harvested) from a donor site (usually the buttock) and is prepared and incubated in a laboratory to separate the epidermis (upper layer of the skin) from the dermis (second layer of the skin). The cells of the epidermis (melanocytes and keratinocytes) are then separated from each other and made into a cell suspension (liquid graft) that can then be transplanted onto the recipient skin (vitiligo skin) once the donor skin has been prepared by removing its upper layer (epidermis) by laser.
Who is suitable to undergo non-cultured melanocyte keratinocyte transplantation?
The best candidates for this technique are those who have:
- Stable disease (no increase in size or increase in number of lesions over at least 12 months)
- Do not develop new vitiligo areas after skin trauma
- No history of abnormal scarring (hypertrophic and keloid)
- Vitiligo affecting the face and neck area or upper body, upper arms or upper legs
How large an area of vitiligo can usually be treated?
Usually 100 square centimetres of vitiligo can be grafted in a single session.
What is the success rate of non-cultured melanocyte transfer technique?
Long term studies indicate more than 75% re-pigmentation can be achieved in approximately 75% of patients undergoing the procedure.
How long does it take to see results?
Re-pigmentation may be seen as early as 1-2 months after the procedure, however final re-pigmentation may take up to 12 months to occur.