title: Is Lesional Stability in Vitiligo More Important Than Disease Stability for Performing Surgical Interventions? Results from a Multicentric Study.
abstract: BACKGROUND
  Ensuring stability of the disease process is essential for undertaking surgical intervention in vitiligo. However, there is no consensus regarding the minimum duration of stability or the relative importance of disease and lesional stability in selecting patients for vitiligo grafting.
  
  
  OBJECTIVE
  This multicentric study aims to assess the relative importance of lesional and disease stability on selecting patients for vitiligo grafting.
  
  
  METHODS
  One hundred seventy patients were recruited into the study and divided into two groups: Group A with lesional stability of >1 year but overall disease stability of only 6-11 months and Group B with overall disease stability of >1 year. Patients underwent either tissue or cellular vitiligo grafting on the selected lesions and the repigmentation achieved was scored from 0 (no repigmentation) to 6 (100% repigmentation). Repigmentation achieved on different sites of the body was compared between the two groups. Adverse effects at both the donor and the recipient sites were also compared.
  
  
  RESULTS
  Of the 170 patients who were enrolled, 82 patients were placed in Group A and 88 patients in Group B. Average repigmentation achieved (on scale of 0 to 6) was 3.8 and 4.04 in Group A and Group B, respectively. In Group A, ≥90% repigmentation was achieved in 36.6% (30/82) patients, while 37.5% (33/88) achieved similar results in Group B. Additionally, 47.6% (39/82) and 53.4% (47/88) of cases achieved partial repigmentation in Group A and Group B, respectively. Perigraft halo was the commonest adverse effect observed in both groups. Statistical analysis revealed no significant differences between the two groups with respect to the repigmentation achieved or adverse effects observed. Repigmentation achieved was the best on the face and neck area, while acral areas responded the least.
  
  
  CONCLUSIONS
  Lesional stability seems to be as relevant as the overall disease stability in selecting patients for surgical intervention in vitiligo.
authors.affiliation: CUTIS Institute of Dermatology, Srinagar, Kashmir, India.
authors.forename: Imran
authors.initials: I
authors.lastname: Majid
authors.affiliation: Venkat Charmalaya Centre for Advanced Dermatology and Postgraduate Training, Bangalore, India.
authors.forename: Venkataram
authors.initials: V
authors.lastname: Mysore
authors.affiliation: Cutis Institute of Advanced Dermatology, Calicut, Kerala, India.
authors.forename: Thurakkal
authors.initials: T
authors.lastname: Salim
authors.affiliation: Wizderm Speciality Clinic, Kolkata, West Bengal, India.
authors.forename: Koushik
authors.initials: K
authors.lastname: Lahiri
authors.affiliation: Command Hospital, Kolkata, West Bengal, India.
authors.forename: Manas
authors.initials: M
authors.lastname: Chatterji
authors.affiliation: Vardhman Mahavir Medical College, Safdarjung Hospital, Delhi, India.
authors.forename: Niti
authors.initials: N
authors.lastname: Khunger
authors.affiliation: Talwar Skin and Laser Centre, Lucknow, Uttar Pradesh, India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Talwar
authors.affiliation: Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India.
authors.forename: S
authors.initials: S
authors.lastname: Sachhidanand
authors.affiliation: Assam Medical College, Dibrugarh, Assam, India.
authors.forename: Shyamanta
authors.initials: S
authors.lastname: Barua
keywords: Duration of stability; lesional stability; stability; surgical treatment; vitiligo