Erbium:YAG laser and cultured epidermis in the surgical therapy of stable vitiligo.

Abstract

OBJECTIVE:

To induce complete and reproducible repigmentation of large "stable" vitiligo lesions by means of autologous cultured epidermal grafts using a rapid, simple, and minimally invasive surgical procedure.

DESIGN:

Achromic epidermis was removed by means of appropriately settled erbium:YAG laser, and autologous epidermal grafts were applied onto the recipient bed. Melanocyte content was evaluated by dopa reaction. The percentage of repigmentation was calculated using a semiautomatic image analysis system.

SETTING:

A biosafety level 3-type cell culture facility, a surgical ambulatory department, and a dermatological department in a hospital.

PATIENTS:

Twenty-one patients with different types of vitiligo were admitted to the study and treated with autologous cultured epidermal grafts. Inclusion criteria were failure of at least 2 standard medical approaches; no therapy for at least 12 months; no progression of old lesions or appearance of new lesions; no Koebner phenomenon within the past 18 months; and no autoimmune disorders.

RESULTS:

The average percentage of repigmentation in 21 patients was 75.9% (1759.7 cm2 repigmented/2315.8 cm2 transplanted). Three patients showed a reactivation of their vitiligo and did not show repigmentation. The remaining 18 patients, with 43 distinct lesions, showed an average percentage of repigmentation of 90% (1759.7 cm2 repigmented/1953.4 cm2 transplanted).

CONCLUSIONS:

Under appropriate conditions, cultured epidermal grafts induce complete repigmentation of stable vitiligo lesions. Erbium:YAG laser surgery can supply a fast and precise tool for disepithelialization, hence allowing treatment of large vitiligo lesions during a single surgical operation.

• Authors: Liliana Guerra, Grazia Primavera, Desanka Raskovic, Graziella Pellegrini, Osvaldo Golisano, Sergio Bondanza, Patrizia Paterna, Giulio Sonego, Tommaso Gobello, Francesco Atzori, Paolo Piazza, Antonio Luci, Michele De Luca
• Journal: Archives of dermatology (Arch Dermatol) Vol. 139 Issue 10 Pg. 1303-10 (Oct 2003) ISSN: 0003-987X [Print] United States
• PMID: 14568835 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Cells, Cultured
• Epidermis (pathology, transplantation)
• Female
• Follow-Up Studies
• Humans
• Laser Therapy
• Male
• Middle Aged
• Time Factors
• Transplantation, Autologous
• Treatment Outcome
• Vitiligo (pathology, surgery)