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Vitiligo is a pigmentation disorder in which melanocyte (the cells that make pigment in the skin) are destroyed. As a result, white patches appear on the skin in different parts of the body. The cause of vitiligo is unknown but research reports suggest that it may occur due to autoimmune, genetic, neural or viral factors. However, with the help of autologous melanocyte transplantation,it is now possible to treat stable cases of vitiligo.
Candidate
A patient with stable and non-progressive vitiligo for more than two years with a total area up to 100 sq.cm.
Procedure
Melanocyte transplantation involves obtaining the split skin graft of about 1/3 th to 1/4 the size of the recipient area from the antero-lateral aspect of the thigh or buttock. From this skin graft, the normal melanocytes are harvested, cultured in a medium and transferred to grow on the vitiligo affected area of the skin. Dressing is done with benzoin seal,which is bandaged with antibiotic impregnated gauze.The patient should avoid all types of tangential movements in the treated area for about 24 hours.The dressing is checked after 6-7 days, and depending on the condition redressing is applied or the patches are left open. Patient is given PUVA therapy after 15 days of transfer to get optimal results. Erythema occurs 1 month post procedure. Re pigmentation is picked up by Woods lamp around the same time.
Result
The chance of the transplanted melanocytes getting rejected by the recipient skin with autologous skin grafting is minimum, and therefore, complete cure can be achieved. Clinically evident re-pigmentation occurs at around 3 to 6 months and continues up to 1 year post treatment.
Benefit
Melanocyte transfer is very simple yet highly effective procedure for the treatment of small stable vitiligo patches. It can be performed in a simple set up without elaborate instrumentation and demanding surgical skills.
