title: Approaches to repigmentation of vitiligo skin: new treatment with ultrasonic abrasion, seed-grafting and psoralen plus ultraviolet A therapy.
abstract: Vitiligo vulgaris is a common disease throughout the world although its pathogenesis is not yet known. The most frequent treatment used for vitiligo is PUVA (psoralen plus ultraviolet A) and topical steroids but against stable refractory vitiligo, various other surgical techniques have been developed such as autografting, epidermal grafting with suction blisters, epithelial sheet grafting, and transplantation of cultured melanocytes. We have discovered a new method using ultrasonic abrasion, seed-grafting and PUVA therapy. The ultrasonic surgical aspirator abrades only the epidermis of recipient sites. This easily and safely removes only the epidermis, even on spotty lesions or intricate regions which are difficult to remove using a conventional motor-driven grinder or liquid nitrogen. Epidermal seed-grafting can cover more area than sheet-grafting, and subsequent PUVA treatment can enlarge the area of pigmentation with coalescence of adjacent grafts. In this article, we provide a general overview of the current surgical therapies including our method for treating stable refractory vitiligo.
authors.affiliation: Department of Dermatology, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan. k-tsukamoto@ych.pref.yamanashi.jp
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Tsukamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Osada
authors.forename: Reiko
authors.initials: R
authors.lastname: Kitamura
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohkouchi
authors.forename: Shinji
authors.initials: S
authors.lastname: Shimada
authors.forename: Osami
authors.initials: O
authors.lastname: Takayama
mesh_terms: D000328:Adult; D003869:Dermabrasion / Q000379:methods*; D004817:Epidermis / Q000473:pathology / Q000601:surgery / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D011701:PUVA Therapy / Q000379:methods*; D016378:Tissue Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation / Q000379:methods*; D014820:Vitiligo / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*