Vitiligo Surgical

Surgical Techniques for Vitiligo: A Review
N. van Geel, K. Ongenae, J.-M. Naeyaert

Although the treatment of vitiligo has improved during the last decade, therapy is still not satisfying for many patients. This is probably due to the fact that the aetiopathogenesis is unknown. Several vitiligo treatment modalities, such as PUVA, UVB and local corticosteroids are currently used in the treatment of active vitiligo. However, these treatments usually induce incomplete repigmentation. Surgical vitiligo methods intended to repigment leucoderma are an interesting therapeutic option if patients have stable disease. Two types of surgical techniques are available: tissue grafts and cellular grafts, with in between autologous cultured epithelial grafts. Tissue grafts are full-thickness punch grafts, split-thickness grafts and suction blister grafts. With tissue grafts, only a limited surface area can be treated but with good results in the majority of cases. Cellular grafts include non-cultured keratinocytes/melanocytes and cultured melanocytes. The exact success rate of repigmentation with cellular grafts is still unknown, since only a small number of studies have been published. Starting from autologous cellular suspensions, epithelial grafts of various compositions can be cultured in vitro. They can be used for larger areas. The purpose of this review is to describe the applications of different vitiligo surgical techniques used to treat recalcitrant vitiligo.

Copyright © 2001 S. Karger AG, Basel


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Author Contacts

J.-M. Naeyaert, MD, PhD
Department of Dermatology
Ghent University Hospital
De Pintelaan 185, B-9000 Ghent (Belgium)
Tel. +32 9 2402298, Fax +32 9 2404996, E-Mail jeanmarie.naeyaert@rug.ac.be

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SURGICAL TECHNIQUES FOR VITILIGO : A Review

Vitiligo treatments - new vitiligo cure method using Tacrolimus

Tacrolimus was as effective in the treatment of vitiligo Clobetasol and how can the best first-line treatment for sensitive skin areas, according to the results of a randomized, double-blind study published in the May issue of Archives of Dermatology.

The hypothesis was that its immunomodulatory properties and safety profile of corticosteroids, tacrolimus ointment may be a better benefit-toxicity ratio and a new therapeutic alternative to topical corticosteroids in children with vitiligo, known that from experience that corticoids Clobetasol is more effective for vitiligo, the pigment often than other topical steroids have failed. That is why they decided instead Clobetasol propionate midpotency other steroids for this study.



The 20 children in this study had untreated vitiligo with topical or systemic more than two months before the study. In each child, two symmetrical lesions of about the size and development time was treated with topical tacrolimus 0.1% and the other with 0.05% Clobetasol propionate two months.

Of the 20 patients, 18 (90%) experienced some repigmentation in digital morphometry, Clobetasol repigmentation of 49.3% and 41.3% for tacrolimus. Adverse events were atrophy and telangiectasia three lesions in two lesions with Clobetasol and a burning sensation in two lesions with tacrolimus.

Tacrolimus is almost as effective as Clobetasol propionate to restore skin color in lesions of vitiligo in children. "Because there was no atrophy or other adverse effects, tacrolimus may be useful for younger patients and for sensitive areas of skin such as eyelids, and must be taken into account other skin disorders currently treated with topical steroids for a long time. It would be interesting to see whether longer periods of treatment, the combination of tacrolimus with other topical agents, or elevated concentrations of tacrolimus can lead to better results than the ones in this series and whether the negative results in Acral can be overwritten with each of these approaches.

In an accompanying editorial, Heidi Plettenberg, MD, to Assmann, MD, and Thomas Ruzicka, MD, of Heinrich-Heine University in Dusseldorf, Germany, considering the photo-therapy and other options for the treatment of vitiligo last. Suggest that tacrolimus is usually more effective in head and neck injuries, and suggest that the low response rate in this study were the limited duration of therapy.

The current data suggest that tacrolimus may represent ... a new option for "vitiligo effective treatment" of childhood vitiligo, with the appropriate use and limited adverse effects," they write. "The efficacy of this immunomodulatory drug provides new evidence for the hypothesis of self-destruction of melanocytes in vitiligo.

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