Autologous epidermal cultures and narrow-band ultraviolet B in the surgical treatment of vitiligo.
BACKGROUND
Vitiligo is an acquired skin disorder with a great social impact. It can be successfully treated with autologous epidermal grafting.


OBJECTIVE
To evaluate the possibility of treating vitiligo by autologous grafting of epidermal cells and narrow-band ultraviolet B (UVB).


METHODS
Autologous epidermal cultures were prepared starting from small biopsies of normally pigmented skin. Cells were cultured on hyaluronic acid membranes using medium supplemented with patient's serum. Cell cultures were grafted onto laser-abraded depigmented areas. Patients underwent narrow-band UVB therapy 3 weeks after grafting.


RESULTS
Repigmentation of the grafted areas started 1 month after transplant and continued until 4 months after grafting. All patients were evaluated 3, 6, 12, and 18 months after grafting. At the 18-month follow-up, repigmentation was observed in 75% of patients with focal and segmental vitiligo and in 30% of patients with generalized vitiligo.


CONCLUSIONS
This therapy can be considered for the treatment of stable vitiligo (especially focal and segmental) resistant to standard therapies. Their results are encouraging from the clinical and esthetic point of view, although the treatment is costly and highly specialized.
Pianigiani
Elisa
E
Department of Dermatology, University of Siena, Policlinico S. Maria alle Scotte, Siena, Italy. pianigianie@unisi.it
Risulo
Massimiliano
M
Andreassi
Andrea
A
Taddeucci
Paolo
P
Ierardi
Francesca
F
Andreassi
Lucio
L
D000293:Adolescent; D000328:Adult; D018929:Cell Culture Techniques; D002478:Cells, Cultured; D005260:Female; D006801:Humans; D008297:Male; D008544:Melanocytes / Q000637:transplantation*; D008875:Middle Aged; D012880:Skin Pigmentation; D016038:Skin Transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014820:Vitiligo / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*