Treatment of stable and recalcitrant vitiligo by autologous miniature punch grafting: A prospective study of 1,000 patients

Background: Stable and refractory vitiligo may be unresponsive to medical therapy. Melanocyte transplantation by punch grafting (PG) can restore the normal pigmentation. Objective: To evaluate the efficacy of PG on repigmentation of vitiligo patches. Methods: Autologous miniature PG was undertaken in 1,000 patients with stable and recalcitrant vitiligo. Test grafting (TG) was done in all the patients. Those who showed negative TG results were excluded from the study. Results: Of the 1,000 patients, 880 (88%) showed positive TG results. In 656 (74.55%) patients, 90-100% repigmentation was achieved. In 93 (10.57%) patients, there was no spread of pigment, while in 21 (2.39%) patients depigmentation of the graft(s) was notices. Of various complications, polka dot appearance (43.98%) and colour mismatch (34.32%) were most frequent. Conclusion: Partial to near-total repigmentation of a vitiligo patch can be achieved by PG.