Long-term results of split-skin grafting in combination with excimer laser for stable vitiligo.
BACKGROUND
Some cases of focal or segmental vitiligo are refractory to medical treatment, and surgical management is the treatment of choice. Postsurgical exposure to ultraviolet B rays can lead to faster and better cosmetic results.


OBJECTIVE
To determine the long-term results of combination therapy with split-skin-thickness grafting and 308-nm excimer laser for the management of stable focal or segmental vitiligo.


METHODS
Seventeen patients (8 female, 9 male) with stable focal or segmental vitiligo not responding to nonsurgical modalities were treated with split-skin-thickness grafting and postgrafting with 32 sessions of 308-nm excimer laser, beginning 2 weeks after surgery. The patients were followed up every year for evaluation of results.


RESULTS
All seventeen (100%) patients showed repigmentation, and overall results were graded as excellent in 12 patients and good in the other five at the end of excimer laser therapy. Final evaluation done at the end of 1 year revealed excellent results in all 17 patients. Two patients developed new vitiligo lesion on other parts of the body during follow-up. None of the patients developed depigmentation of the transplanted skin.


CONCLUSIONS
Combination treatment with split-skin-thickness grafting and postsurgical exposure to 308-nm excimer laser in patients with stable focal or segmental vitiligo can lead to fast, cosmetically good, long-lasting results.
Al-Mutairi
Nawaf
N
Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait. nalmut@usa.net
Manchanda
Yashpal
Y
Al-Doukhi
Azari
A
Al-Haddad
Ahmad
A
D000328:Adult; D005145:Face; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology; D054018:Lasers, Excimer / Q000009:adverse effects / Q000627:therapeutic use*; D007866:Leg; D008297:Male; D009333:Neck; D010789:Phototherapy / Q000009:adverse effects; D011182:Postoperative Care; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014467:Ultraviolet Therapy; D014820:Vitiligo / Q000601:surgery*; D055815:Young Adult