Comparative study of flip-top transplantation and punch grafting in stable vitiligo.

ABSTRACT

BACKGROUND: Because of limitations of medical treatment in vitiligo, various surgical techniques have been devised. There is a scarcity of comparative studies of surgical techniques in vitiligo. OBJECTIVE: To compare the effectiveness and side-effect profile of flip-top transplantation (FTT) and punch grafting (PG) in patients with stable vitiligo. MATERIALS AND METHODS: Twenty patients with stable vitiligo were treated using PG and FTT on 26 lesions; 156 grafts were taken (78 PG, 78 flip-top grafts). They were graded for response in the form of repigmentation as excellent (91-100%), very good (76-90%), good (51-75%), fair (31-50%), poor (<30%). Onset and maximum pigment spread were observed. RESULTS: Sixty-five percent of our patients showed excellent repigmentation with FTT, versus 50% with PG (p = .44). Thirty percent of patients with FTT and 40% with PG had side effects. The differences in onset of repigmentation, completion, and pigment spread between the two techniques were statistically significant (p < .001). CONCLUSIONS: Flip-top transplantation was equally effective as PG for treating vitiligo, although graft uptake rate was higher with FTT, with more pigment spread, and cost less.