Double-blind placebo-controlled study of autologous transplanted epidermal cell suspensions for repigmenting vitiligo.
OBJECTIVE
To investigate the efficacy of epidermal noncultured cellular grafting in patients with vitiligo and the role of postinflammatory, spontaneous, or UV-induced pigmentation in obtaining repigmentation.


METHODS
A prospective, randomized, double-blind, placebo-controlled study.


METHODS
Ambulatory patients in an institutional practice. Patients were followed up for 3 to 12 months.


METHODS
A total of 33 paired, symmetrically distributed leukodermic lesions, all resistant to therapy, were observed in 28 patients. Nineteen patients appeared to have a stable vitiligo (group 1), whereas there was doubt about the stability of the disease in 9 patients (group 2).


METHODS
After laser ablation, a hyaluronic acid-enriched cellular graft was applied to 1 lesion while the paired lesion received placebo. Three weeks later all lesions were exposed to UV irradiation twice per week for approximately 2 months.


METHODS
Primarily, the percentage of repigmentation was assessed after 3, 6, and 12 months using a digital image analysis system. The repigmentation pattern was also evaluated after 1 and 3 months.


RESULTS
A strongly significant difference between cellular grafts and placebo was observed after 3, 6, and 12 months (P<.001, P = .002, and P = .002, respectively). In group 1, repigmentation of at least 70% of the treated area was achieved in 55%, 57%, and 77% of the actively treated lesions 3, 6, and 12 months after treatment, whereas in group 2 repigmentation of at least 70% of the treated area was not observed at any time point. The repigmentation pattern was diffuse in 94% of the responding patients.


CONCLUSIONS
After a strict preoperative selection for disease stability, transplantation resulted in repigmentation of at least 70% of the treated area in most actively treated vitiligo lesions. Repigmentation was primarily caused by the transplanted melanocytes.
van Geel
Nanny
N
Department of Dermatology, Ghent University Hospital, 9000 Ghent, Belgium.
Ongenae
Katia
K
De Mil
Martine
M
Haeghen
Yves Vander
YV
Vervaet
Chris
C
Naeyaert
Jean Marie
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002478:Cells, Cultured / Q000637:transplantation; D004311:Double-Blind Method; D000078404:Epidermal Cells; D004817:Epidermis / Q000637:transplantation*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012880:Skin Pigmentation; D013535:Suspensions; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014820:Vitiligo / Q000473:pathology / Q000601:surgery*
D013535:Suspensions