Cell transplantation helps repigment skin
MedWire News: The melanocyte-keratinocyte transplantation procedure (MKTP) results in good or excellent repigmentation in approximately half of patients who undergo the outpatient surgery, research shows.
"Patients with segmental or focal vitiligo may benefit most from this procedure, although it may be helpful for other groups as well," report Iltefat Hamzavi (Henry Ford Hospital, Detroit, Michigan, USA) and colleagues.
The findings, which are published in the Journal of American Academic Dermatology, are based on the results of a single academic dermatology clinic that treated 28 patients with 36 procedures.
Cellular grafting is a distinctive skin transplantation that allows clinicians to treat large depigmented lesions on the skin using small donor skin samples, the team explains. With MKTP, melanocytes and keratinocytes are harvested from healthy skin, separated from the epidermal pieces into a cell suspension, and applied to the recipient area.
In this study, the cells were taken from the lateral aspect of the gluteal region, harvested from an area approximately a 10th the size of the recipient region. A mean area of 48 cm2 was treated per procedure, and the majority of the treated lesions were in the extremities, with 36% of lesions on the face, and 12% in the trunk.
Overall, "excellent" repigmentation was achieved in 17% of the treated patients, and "good" repigmentation achieved in 31% of patients. However, 41% of patients had a poor response to MKTP, and 10% had a fair response.
Using a scoring index to assess vitiligo, the researchers observed an average 45% reduction in the Vitiligo Area Scoring Index (VASI), a result suggestive of improvement. The VASI score also suggested difference in response to treatment across ethnicities, with White patients showing a 61% improvement in the VASI compared with a 30% change in other patients.
The researchers point out, however, that White patients had more segmental and focal lesions; these lesion types demonstrated a better response to MKTP compared with generalized lesions.
Lesions in the neck and face had the best response to treatment, with 67% of treated patients having excellent or good repigmentation following MKTP. Just13% of lesions in the extremities had excellent repigmentation and 25% had a good response.
Vitiligo on the lips and fingertips had a poor response to treatment, note Hamzavi and colleagues.
The researchers point out that MKTP is an evolving treatment in Europe, Asia, and the Middle East, but is infrequently used in the USA. "Given our findings, US dermatologists now have an additional option for the treatment of this disease," they conclude.
By MedWire Reporters