Minimally Invasive Repigmentation Technique for Vitiligo Promising

Vitiligo on a man's arm
Vitiligo on a man’s arm
Although many surgical techniques for the treatment of vitiligo exist, response is variable.

Noncultured, extracted follicular outer root sheath cell suspension transplantation is a novel, minimally invasive treatment for the management of patients with stable vitiligo, according to results of a recent prospective case series published in the International Journal of Dermatology.

The investigators sought to examine the clinical efficacy of this technique, and to determine the viability and cell composition of the suspension. The study was carried out in the outpatient department of dermatology at the All India Institute of Medical Sciences in New Delhi from 2011 to 2013.

A total of 25 patients (10 men, 15 women) with stable vitiligo were enrolled; mean age was 24.5±3.06 years (range, 18-36 years). Patients were followed-up at 1, 4, 16, and 24 weeks, with repigmentation assessed subjectively.

After the extraction and suspension process, most participants began to experience repigmentation in the form of small round to oval, discrete normal pigmented macules at 1 to 3 months. Mean repigmentation at the end of 1 month was 6%±3.7%, improving to 28%±13.6% and 52%±25.1% at the end of 3 and 6 months, respectively. Overall, good repigmentation (>75%) was observed in 32% (8/25) of the patients, moderate repigmentation (50%-75%) in 24% (6/25) of the patients, and poor repigmentation (<50%) in 44% (11/25) of the patients.

Recipient site infection was reported in 16% (4/25) of the patients, and a color mismatch was observed in 44% (11/25) of the patients.

The researchers concluded that noncultured, extracted follicular outer root sheath cell suspension is a useful, minimally invasive technique with promising efficacy for the management of vitiligo. Additional studies with larger sample sizes and longer follow-up are warranted to confirm these findings.

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Kumar P, Bhari N, Tembhre MK, et al. Study of efficacy and safety of noncultured, extracted follicular outer root sheath cell suspension transplantation in the management of stable vitiligo [published online October 3, 2017]. Int J Dermatol. doi: 10.1111/ijd.13759