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Long-term follow-up of patients undergoing autologous noncultured melanocyte-keratinocyte transplantation for vitiligo and other leukodermas - 14/12/17

Doi : 10.1016/j.jaad.2017.01.056 
Narumol Silpa-Archa, MD a, b, James L. Griffith, MD a, Richard H. Huggins, MD a, Marsha D. Henderson, MD a, Holly A. Kerr, MD a, Gordon Jacobsen, MS c, Sanjeev V. Mulekar, MD a, d, Henry W. Lim, MD a, Iltefat H. Hamzavi, MD a,
a Department of Dermatology, Multicultural Dermatology Center, Henry Ford Hospital, Detroit, Michigan 
b Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand 
c Department of Public Health Sciences, Henry Ford Hospital, Detroit, Michigan 
d National Center for Vitiligo and Psoriasis, Riyadh, Saudi Arabia 

Reprint requests: Iltefat H. Hamzavi, MD, Department of Dermatology, Henry Ford Hospital, 3031 W Grand Boulevard, Suite 800, Detroit, MI 48202.Department of DermatologyHenry Ford Hospital3031 W Grand Boulevard, Suite 800DetroitMI48202

Abstract

Background

Persistence of pigmentation after a melanocyte-keratinocyte transplantation procedure (MKTP) is an important consideration for efficacy.

Objective

We sought to determine long-term repigmentation of MKTP in vitiligo and other leukodermas.

Methods

A retrospective review of electronic medical records was conducted for all MKTPs performed at Henry Ford Hospital between January 2009 and April 2014. Repigmentation was assessed by a 5-point grading scale (poor to excellent) and Vitiligo Area Scoring Index (VASI).

Results

One hundred patients had MKTP performed at 236 anatomically-based lesions (ABLs); 63 patients with 157 ABLs had long-term data available (12-72 months; median, 24 months). Segmental vitiligo, nonsegmental vitiligo, and physical leukoderma demonstrated improvement in VASI scores: −75.6 ± 24.6%, −59.2 ± 36.6%, and −32.4 ± 33.5%, respectively. In vitiligo, at 24, 48, and 72 months after MKTP, 53%, 64%, and 53% of ABLs, respectively, maintained >75% repigmentation. Skin phototype, age, and anatomic location of ABLs had no significant effect on the outcome of treatment.

Limitations

Limitations of the study include the retrospective design with uncontrolled, postoperative adjuvant treatments and inconsistent compliance to scheduled follow-up evaluations.

Conclusions

MKTP provides satisfactory long-term repigmentation in the majority of appropriately selected patients with leukoderma. MKTP can maintain repigmentation for at least 72 months.

Le texte complet de cet article est disponible en PDF.

Key words : autologous transplantation, epidermal suspension, keratinocyte, leukoderma, long term, melanocyte, VASI, vitiligo

Abbreviations used : ABL, MKTP, NSV, SPT, SV, VASI


Plan


 This study was partially supported by the Shahani Foundation and Multicultural Dermatology Fund, Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
 Disclosure: Dr Hamzavi had served as a consultant for Johnson & Johnson, was an investigator for Johnson & Johnson, Ferndale Laboratories, Estee Lauder, and Allergan and had received honoraria from Allergan. Dr Lim had served as a consultant for Pierre Fabre and had received grants and research support from Estee Lauder, Ferndale Laboratories, and Allergan. Dr Griffith had served as an investigator for Ferndale Laboratories. Drs Silpa-Archa, Huggins, Henderson, Kerr, and Mulekar and Mr Jacobsen had no conflicts of interest to declare.
 This study was presented as a poster presentation at the 23rd World Congress of Dermatology, Vancouver, Canada (June 2015). Contents of this manuscript have not been previously published and are not currently submitted elsewhere for publication.


© 2017  Publié par Elsevier Masson SAS.
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Vol 77 - N° 2

P. 318-327 - août 2017 Retour au numéro
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