Effects of narrow-band ultraviolet B radiation on the efficacy of autologous epidermal grafting for vitiligo / 中华皮肤科杂志

Objective To evaluate the clinical efficacy of autologous epidermal grafting combined with narrow?band ultraviolet B(NB?UVB)radiation for the treatment of vitiligo, and to explore their possible action mechanisms. Methods Totally, 30 patients with vitiligo were randomly and equally divided into 2 groups:epidermal grafting group treated with autologous epidermal grafting alone, and combination group treated with both autologous epidermal grafting and NB?UVB radiation. Fifteen healthy volunteers served as the healthy control group. Enzyme?linked immunosorbent assay(ELISA)was performed to detect the levels of interleukin?18(IL?18), tumor necrosis factor?α(TNF?α)and soluble intercellular adhesion molecule?1 (sICAM?1) in interstitial fluid from the patients before and after the treatment, as well as from the healthy controls. Therapeutic effects were evaluated after 3?month treatment. Results Before the treatment, the epidermal grafting group and combination group both showed significantly increased levels of IL?18(0.985 ± 0.305μg/L, 1.008 ± 0.399μg/L, respectively), TNF?α(1.132 ± 0.313μg/L, 1.147 ± 0.474μg/L, respectively)and sICAM?1(1.215 ± 0.284μg/L, 1.221 ± 0.432μg/L, respectively)in interstitial fluid compared with the healthy control group(all P<0.01). The levels of the three cytokines in the combination group almost all returned to normal after the 3?month treatment. In addition, the combination group showed a significantly higher response rate compared with the epidermal grafting group(68.9%vs. 43.8%, P<0.05). Conclusion Immune abnormalities exist in local lesions of patients with vitiligo, and NB?UVB radiation can increase the success rate of epidermal grafting likely by regulating the body′s immune function.

The Efficacy of Autologous Epidermal Grafting Based on Clinical Types for the Treatment of 320 Stable Vitiligo Lesions / 대한피부과학회지

BACKGROUND: Autologous epidermal grafting was reported by several authors to be successfully used for the treatment of stable vitiligo lesions. However, there have been only a few studies with a sufficient number of cases and long-term follow up. OBJECTIVE: The purpose of this study was to evaluate the long-term efficacy of autologous epidermal grafting for the treatment of stable vitiligo lesions. METHODS: We evaluated 187 patients (320 lesions) after autologous epidermal graftings using suction blistered epidermis. The effects were analyzed based on age, sex, clinical types, recipient sites, the ablative methods for recipient sites and the time after the operation. RESULTS: Autologous epidermal grafting was more effective for younger patients, for asymmetrical types and when the recipient sites were the head and neck. Pigment production increase until about 3 years after the operation was also found for patients who were evaluated regularly for more than 3 years. CONCLUSION: Autologous epidermal grafting is a safe, effective treatment modality for stable vitiligo. In order to determine the long-term efficacy of epidermal grafting, doctors should closely observe for at least 3 years after the grafting.

Autologous Epidermal grafting in Treatment of Vitiligo: Evaluation for Its Effectiveness and Patient Satisfaction / 대한피부과학회지

BACKGROUND: Autologous epidermal grafting has been reported to be successfully used in the treatment of vitiligo by several authors and is in widespread use at present time. But, the incomplete repigmentation is common and remains stressful to the patients. OBJECTIVE: The purpose of this study is to evaluate the effectiveness of autologous epidermal grafting in the treatment of vitiligo and investigate the patient satisfaction with the result. MATERIALS AND METHODS: The evaluation was conducted on 42 patients with vitiligo who had been treated by autologous epidermal grafting using suction blistered epidermis. We also investigated the patient satisfaction by interviewing with several questions. RESULTS AND CONCLUSIONS: The effectiveness of the repigmentation objectively evaluated by two dermatologists is high and favorable repigmentation (more than 80 percent) was shown in 76.2% of all the patients. But, the subjective satisfaction of the patients proved not very good, compared with the objective clinical improvement and 40.5% of the patients were unsatisfied with the results. We think the doctors should make the patients understand the expectable results from the epidermal grafting for the best patient satisfaction.