title: Vitiligo: analysis of grafting versus curettage alone, using melanocyte morphology and reverse transcriptase polymerase chain reaction for tyrosinase mRNA.
abstract: 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.
authors.affiliation: Department of Dermatology, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil. carmachado@terra.com.br
authors.forename: Carlos D'Aparecida dos Santos
authors.initials: CD
authors.lastname: Machado Filho
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: Almeida
authors.forename: Rodrigo Sestito
authors.initials: RS
authors.lastname: Proto
authors.forename: Gilles
authors.initials: G
authors.lastname: Landman
mesh_terms: 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*
chemical_list: D012333:RNA, Messenger; D014442:Monophenol Monooxygenase