Melanocyte-keratinocyte transplantation procedure in the treatment of vitiligo: The experience of an academic medical center in the United States - 16/04/12
Reprint requests: Iltefat H. Hamzavi, MD, Department of Dermatology, Henry Ford Hospital, 3031 W Grand Blvd, Suite 800, Detroit, MI 48202.Abstract |
Background |
Vitiligo is a disfiguring disease with limited treatment options. Surgical treatment is underused in the United States because of perceived risk of infection, costs, and difficulty of the procedure.
Objective |
We sought to determine the efficacy and safety of the melanocyte-keratinocyte transplantation procedure (MKTP) in an academic dermatology department in the United States.
Methods |
This prospective, uncontrolled, open-label study enrolled patients aged 18 years or older with a self-reported history of vitiligo and no new or expanding lesions for at least 6 months before surgery. Patients with a history of koebnerization or keloid formation were excluded. Patients underwent autologous MKTP. Repigmentation during a 3- to 6-month follow-up period was assessed categorically and by modified Vitiligo Area Scoring Index. Safety was assessed by frequency of adverse events.
Results |
Of the 28 patients who underwent 36 procedures, 23 patients who underwent 29 procedures completed the 3- to 6-month follow-up period. Data for these 29 procedures show excellent repigmentation (ie, 95%-100%) after the MKTP in 17%, and good repigmentation (ie, 65%-94%) in 31%. Fair (64%-25%) and poor (24%-0%) repigmentation were achieved in 10% and 41% of patients, respectively. Average percent change in Vitiligo Area Scoring Index was −45% (95% confidence interval −64% to −26%), signifying an improvement in pigmentation.
Limitations |
Limitations include small sample size and lack of a control group.
Conclusions |
The MKTP is an effective and well-tolerated procedure based upon categorical and Vitiligo Area Scoring Index assessments of repigmentation.
Le texte complet de cet article est disponible en PDF.Key words : autologous transplantation, keratinocytes, leukoderma, melanocytes, skin pigmentation, surgery, vitiligo
Abbreviations used : BSA, CI, MKTP, VASI
Plan
| Supported in part by the C. S. Livingood Education Fund, and the Shahani Foundation. |
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| Disclosure: Dr Lim serves as a consultant for La Roche-Posay/L’Oreal, Orfagen, Dow Pharmaceutical Sciences. The Henry Ford Hospital Department of Dermatology has received a research grant on photobiology from Johnson & Johnson. Dr Hamzavi serves as a consultant for Kythera. He has worked as an investigator with Abbott, Johnson & Johnson, Centocor, Dow Pharm, Cipher, and Pfizer. Dr Ozog serves as an investigator for Lumenis. Drs Huggins, Henderson, Mulekar, and Kerr, and Mr Jabobsen have no conflicts of interest to declare. |
Vol 66 - N° 5
P. 785-793 - mai 2012 Retour au numéro
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