BJECTIVE: To induce complete and reproducible repigmentation of large "stable" vitiligo lesions by means of autologous cultured epidermal grafts using a rapid, simple, and minimally invasive surgical procedure. DESIGN: Achromic epidermis was removed by means of appropriately settled erbium:YAG laser, and autologous epidermal grafts were applied onto the recipient bed. Melanocyte content was evaluated by dopa reaction. The percentage of repigmentation was calculated using a semiautomatic image analysis system. SETTING: A biosafety level 3-type cell culture facility, a surgical ambulatory department, and a dermatological department in a hospital. PATIENTS: Twenty-one patients with different types of vitiligo were admitted to the study and treated with autologous cultured epidermal grafts. Inclusion criteria were failure of at least 2 standard medical approaches; no therapy for at least 12 months; no progression of old lesions or appearance of new lesions; no Koebner phenomenon within the past 18 months; and no autoimmune disorders. RESULTS: The average percentage of repigmentation in 21 patients was 75.9% (1759.7 cm2 repigmented/2315.8 cm2 transplanted). Three patients showed a reactivation of their vitiligo and did not show repigmentation. The remaining 18 patients, with 43 distinct lesions, showed an average percentage of repigmentation of 90% (1759.7 cm2 repigmented/1953.4 cm2 transplanted). CONCLUSIONS: Under appropriate conditions, cultured epidermal grafts induce complete repigmentation of stable vitiligo lesions. Erbium:YAG laser surgery can supply a fast and precise tool for disepithelialization, hence allowing treatment of large vitiligo lesions during a single surgical operation.

Erbium:YAG laser and cultured epidermis in the surgical therapy of stable vitiligo / Guerra, L; Primavera, G; Raskovic, D; Pellegrini, Graziella; Golisano, O; Bondanza, S; Paterna, P; Sonego, G; Gobello, T; Atzori, F; Piazza, P; Luci, A; DE LUCA, Michele. - In: ARCHIVES OF DERMATOLOGY. - ISSN 0003-987X. - STAMPA. - 139:10(2003), pp. 1303-1310. [10.1001/archderm.139.10.1303]

Erbium:YAG laser and cultured epidermis in the surgical therapy of stable vitiligo.

PELLEGRINI, Graziella;DE LUCA, Michele
2003

Abstract

BJECTIVE: To induce complete and reproducible repigmentation of large "stable" vitiligo lesions by means of autologous cultured epidermal grafts using a rapid, simple, and minimally invasive surgical procedure. DESIGN: Achromic epidermis was removed by means of appropriately settled erbium:YAG laser, and autologous epidermal grafts were applied onto the recipient bed. Melanocyte content was evaluated by dopa reaction. The percentage of repigmentation was calculated using a semiautomatic image analysis system. SETTING: A biosafety level 3-type cell culture facility, a surgical ambulatory department, and a dermatological department in a hospital. PATIENTS: Twenty-one patients with different types of vitiligo were admitted to the study and treated with autologous cultured epidermal grafts. Inclusion criteria were failure of at least 2 standard medical approaches; no therapy for at least 12 months; no progression of old lesions or appearance of new lesions; no Koebner phenomenon within the past 18 months; and no autoimmune disorders. RESULTS: The average percentage of repigmentation in 21 patients was 75.9% (1759.7 cm2 repigmented/2315.8 cm2 transplanted). Three patients showed a reactivation of their vitiligo and did not show repigmentation. The remaining 18 patients, with 43 distinct lesions, showed an average percentage of repigmentation of 90% (1759.7 cm2 repigmented/1953.4 cm2 transplanted). CONCLUSIONS: Under appropriate conditions, cultured epidermal grafts induce complete repigmentation of stable vitiligo lesions. Erbium:YAG laser surgery can supply a fast and precise tool for disepithelialization, hence allowing treatment of large vitiligo lesions during a single surgical operation.
2003
139
10
1303
1310
Erbium:YAG laser and cultured epidermis in the surgical therapy of stable vitiligo / Guerra, L; Primavera, G; Raskovic, D; Pellegrini, Graziella; Golisano, O; Bondanza, S; Paterna, P; Sonego, G; Gobello, T; Atzori, F; Piazza, P; Luci, A; DE LUCA, Michele. - In: ARCHIVES OF DERMATOLOGY. - ISSN 0003-987X. - STAMPA. - 139:10(2003), pp. 1303-1310. [10.1001/archderm.139.10.1303]
Guerra, L; Primavera, G; Raskovic, D; Pellegrini, Graziella; Golisano, O; Bondanza, S; Paterna, P; Sonego, G; Gobello, T; Atzori, F; Piazza, P; Luci, A; DE LUCA, Michele
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