Vitiligo: analysis of grafting versus curettage alone, using melanocyte morphology and reverse transcriptase polymerase chain reaction for tyrosinase mRNA.
OBJECTIVE
Recent studies have indicated that vitiligo areas contain inactive or dormant melanocytes. Melanin synthesis is related to tyrosinase presence and indicative of active metabolic state. The aim of this study was to compare repigmentation, epidermal melanocyte distribution and tyrosinase mRNA detection through reverse transcriptase polymerase chain reaction, in tissue samples of vitiligo, before and after curettage, with or without subsequent autologous skin graft using a new method.


METHODS
Prospective, in the Department of Dermatology, Faculdade de Medicina do ABC, Santo André.


METHODS
Two vitiligo areas were curetted. One subsequently received grafted normal sacral autologous skin, whereas the other had no further treatment. The curetted areas were examined after 30 days, to evaluate the degree of repigmentation. The melanocyte percentages and tyrosinase mRNA presence in normal skin and vitiligo areas, before and after curettage and grafting, were compared.


RESULTS
Complete repigmentation was seen in all grafted areas, whereas non-grafted curetted vitiligo presented partial repigmentation. The melanocyte percentage in grafted areas was greater than in non-treated vitiligo skin (p = 0.01) and skin with curettage alone (p = 0.015). Tyrosinase mRNA was negative in 93.75% of non-treated vitiligo areas. After treatment (curettage alone or curettage and grafting), all lesions became positive for tyrosinase mRNA.


CONCLUSIONS
Metabolically inactive or dormant melanocytes are probably present within vitiligo areas, and may be activated by exogenous or endogenous stimuli.
Machado Filho
Carlos D'Aparecida dos Santos
CD
Department of Dermatology, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil. carmachado@terra.com.br
Almeida
Fernando Augusto
FA
Proto
Rodrigo Sestito
RS
Landman
Gilles
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002452:Cell Count; D002648:Child; D003475:Curettage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008544:Melanocytes; D008875:Middle Aged; D014442:Monophenol Monooxygenase / Q000032:analysis* / Q000235:genetics; D011446:Prospective Studies; D012333:RNA, Messenger / Q000032:analysis*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014820:Vitiligo / Q000201:enzymology / Q000473:pathology / Q000601:surgery*
D012333:RNA, Messenger; D014442:Monophenol Monooxygenase