Long-term follow-up of patients undergoing autologous noncultured melanocyte-keratinocyte transplantation for vitiligo and other leukodermas.
Silpa-Archa N, Griffith JL, Huggins RH, Henderson MD, Kerr HA, Jacobsen G, Mulekar S, Lim HW, Hamzavi IH. Long-term follow-up of patients undergoing autologous noncultured melanocyte-keratinocyte transplantation for vitiligo and other leukodermas.. Journal of the American Academy of Dermatology 2017; 77(2):318-327.
Journal of the American Academy of Dermatology
BACKGROUND: Persistence of pigmentation after a melanocyte-keratinocyte transplantation procedure (MKTP) is an important consideration for efficacy.
OBJECTIVE: We sought to determine long-term repigmentation of MKTP in vitiligo and other leukodermas.
METHODS: A retrospective review of electronic medical records was conducted for all MKTPs performed at Henry Ford Hospital between January 2009 and April 2014. Repigmentation was assessed by a 5-point grading scale (poor to excellent) and Vitiligo Area Scoring Index (VASI).
RESULTS: One hundred patients had MKTP performed at 236 anatomically-based lesions (ABLs); 63 patients with 157 ABLs had long-term data available (12-72 months; median, 24 months). Segmental vitiligo, nonsegmental vitiligo, and physical leukoderma demonstrated improvement in VASI scores: -75.6 ± 24.6%, -59.2 ± 36.6%, and -32.4 ± 33.5%, respectively. In vitiligo, at 24, 48, and 72 months after MKTP, 53%, 64%, and 53% of ABLs, respectively, maintained >75% repigmentation. Skin phototype, age, and anatomic location of ABLs had no significant effect on the outcome of treatment.
LIMITATIONS: Limitations of the study include the retrospective design with uncontrolled, postoperative adjuvant treatments and inconsistent compliance to scheduled follow-up evaluations.
CONCLUSIONS: MKTP provides satisfactory long-term repigmentation in the majority of appropriately selected patients with leukoderma. MKTP can maintain repigmentation for at least 72 months.
Medical Subject Headings
Adolescent; Adult; Child; Female; Follow-Up Studies; Humans; Keratinocytes; Male; Melanocytes; Middle Aged; Retrospective Studies; Severity of Illness Index; Skin Pigmentation; Time Factors; Transplantation, Autologous; Treatment Outcome; Vitiligo; Young Adult