Acral vitiligo and lesions over joints treated with non-cultured epidermal cell suspension transplantation.

BACKGROUND: Vitiligo is a disfiguring condition that can cause considerable psychological distress to patients. Vitiligo lesions on acral areas and joints are considered difficult to treat, and they are unsuitable for surgical treatment because of their poor response. There are few studies on the management of those lesions with noncultured epidermal cell suspension transplantation. AIM: To evaluate the efficacy of a modified procedure using noncultured epidermal cell suspension transplantation in the management of vitiligo lesions over acral areas and joints. METHODS: We retrospectively analysed data for patients who had undergone non-cultured epidermal cell suspension transplantation for treatment of vitiligo. In total, 36 patients with 80 lesions over acral areas and joints were reviewed: 33 patients had generalized vitiligo, while the remaining three patients had focal vitiligo, and they had been followed up for 6-18 months. RESULTS: Of the 80 treated lesions, 51 had regained > 75% repigmentation and 23 had regained 50-75% repigmentation. The remaining six lesions, which were all no the distal fingers or toes and the ankle joint, had a poor response. CONCLUSIONS: Non-cultured epidermal cell suspension transplantation was successful in producing some degree of repigmentation in our patients, and could be a useful therapy for vitiligo lesions.

Vitiligo surgery: its evolution as a definite treatment in the stable vitiligo.

Vitiligo is a common pigmentary disorder which causes immense psychosocial impact on the patients. This condition is still an enigma in terms of its pathogenesis and management. Although there are various treatment modalities, till date none of it takes care of the cause. Surgical management has evolved significantly and given a ray of hope in stable vitiligo. The main purpose is to review the various surgical modalities available along with a look on the milestones and an effort to find answers to "why, when, whom and how" of vitiligo surgery. This article is based on the review of medical literature regarding various surgical management of vitiligo and also author's experience in this particular field. In addition with this review authors tried to shed light on the factors affecting the outcome of vitiligo surgery. The outcome any surgical procedure in vitiligo depends on the proper patient selection, a proper knowledge of this condition and also about its mystery, an expertise in the procedure and a dedication towards patient care. It is certain that surgical modality will be chosen by many with the hope that it succeeds where medical modality fails. However, there is lot of scope for improvement. So more research should happen in this field so that our aim will shift from "any repigmentation" to "complete and normal repigmentation" and we can achieve a scar less healing of those "bruised souls".