Treatment of "stable" vitiligo by timedsurgery and transplantation of cultured epidermal autografts

被引:102
作者
Guerra, L
Capurro, S
Melchi, F
Primavera, G
Bondanza, S
Cancedda, R
Luci, A
De Luca, M
Pellegrini, G
机构
[1] Ist Dermopat Immacolata, Lab Tissue Engn, I-00040 Pomezia, Rome, Italy
[2] Ist Dermopat Immacolata, Div Dermatol 2, I-00040 Pomezia, Rome, Italy
[3] Ist Dermopat Immacolata, Div Dermatol 5, I-00040 Pomezia, Rome, Italy
[4] Ist Dermopat Immacolata, Div Dermatol Surg, I-00040 Pomezia, Rome, Italy
[5] Osped San Martino Genova, Dept Plast Surg, Genoa, Italy
[6] Ist Nazl Ric Canc, Ctr Biotecnol Avanzate, I-16132 Genoa, Italy
[7] Univ Genoa, Dipartimento Oncol Biol & Genet, Genoa, Italy
关键词
D O I
10.1001/archderm.136.11.1380
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Objective: To optimize melanocyte/keratinocyte cocultivation and to evaluate the effectiveness of autologous cultured epidermal grafts in the surgical treatment of stable vitiligo. Design: After optimization of melanocyte/keratinocyce cultures, achromic lesions were disepithelialized by means of programmed diathermosurgery (Timedsurgery) and covered with autologous epidermal grafts prepared from secondary cultures; Melanocyte content was evaluated by dopa reaction. The percentage of repigmentation was calculated using a semiautomatic image analysis system. Setting: A biosafety level 3 cell culture facility and a dermatological department in a hospital: Patients: Thirty-two patients carrying different types of vitiligo were admitted to the study and treated with autologous cultured epidermal grafts. Inclusion criteria were (1) failure of at least 2 standard medical. approaches; (2) no therapy for at least 12 months; (3) absence of progression of old lesions, absence of appearance of new lesions, and absence of Koebner phenomenon within the past 18 months; and (4) absence of autoimmune disorders. Results: One hundred five achromic lesions (a total of 6078.2 cm(2)) were treated. The average percentage of repigmentation, evaluated after 12 to 36 months of:follow-up, was 77%. Independent of the type of vitiligo, average percentages of repigmentation of extremities and periorificial sites were 8% (31.8 cm(2) repigmented/420.5 cm(2) transplanted) and 35% (17.6 cm(2) repigmented/50.0 cm(2) transplanted), respectively. Percentages of repigmentation of all other body sites ranged from 88% to 96% C4329.7 cm(2) repigmented/4675.2 cm(2) transplanted). Color matching was good, and scar formation was not observed. Conclusion: Cultured epidermal grafts can be considered a real therapeutic surgical alternative for "stable" but not lip-tip vitiligo.
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页码:1380 / 1389
页数:10
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