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Comparative Study
. 2005 Jul 7;123(4):187-91.
doi: 10.1590/s1516-31802005000400006.

Vitiligo: analysis of grafting versus curettage alone, using melanocyte morphology and reverse transcriptase polymerase chain reaction for tyrosinase mRNA

Carlos D'Aparecida dos Santos Machado Filho  1 , Fernando Augusto Almeida, Rodrigo Sestito Proto, Gilles Landman
Affiliations
Comparative Study

Vitiligo: analysis of grafting versus curettage alone, using melanocyte morphology and reverse transcriptase polymerase chain reaction for tyrosinase mRNA

Carlos D'Aparecida dos Santos Machado Filho et al. Sao Paulo Med J. .

Abstract
in English, Portuguese

Context and objective: Recent studies have indicated that vitiligo areas contain inactive or dormant melanocytes. Melanin synthesis is related to tyrosinase presence and indicative of active metabolic state. The aim of this study was to compare repigmentation, epidermal melanocyte distribution and tyrosinase mRNA detection through reverse transcriptase polymerase chain reaction, in tissue samples of vitiligo, before and after curettage, with or without subsequent autologous skin graft using a new method.

Design and setting: Prospective, in the Department of Dermatology, Faculdade de Medicina do ABC, Santo André.

Methods: Two vitiligo areas were curetted. One subsequently received grafted normal sacral autologous skin, whereas the other had no further treatment. The curetted areas were examined after 30 days, to evaluate the degree of repigmentation. The melanocyte percentages and tyrosinase mRNA presence in normal skin and vitiligo areas, before and after curettage and grafting, were compared.

Results: Complete repigmentation was seen in all grafted areas, whereas non-grafted curetted vitiligo presented partial repigmentation. The melanocyte percentage in grafted areas was greater than in non-treated vitiligo skin (p = 0.01) and skin with curettage alone (p = 0.015). Tyrosinase mRNA was negative in 93.75% of non-treated vitiligo areas. After treatment (curettage alone or curettage and grafting), all lesions became positive for tyrosinase mRNA.

Conclusion: Metabolically inactive or dormant melanocytes are probably present within vitiligo areas, and may be activated by exogenous or endogenous stimuli.

CONTEXTO E OBJETIVO:: Estudos recentes têm indicado que áreas de vitiligo contêm melanócitos inativos ou dormentes. A síntese de melanina está relacionada com a presença de tirosinase é indicadora de estado metabólico ativo. O escopo deste artigo é comparar repigmentação, distribuição epidérmica de melanócitos e detecção do RNAm de tirosinase através da reação de polimerase em cadeia por transcriptase reversa, em amostras de tecido de vitiligo, antes e após curetagem, seguido ou não por uma nova técnica de enxerto autólogo de pele.

TIPO DE ESTUDO E LOCAL:: Prospectivo, na Disciplina de Dermatologia da Faculdade de Medicina do ABC, Santo André.

MÉTODOS:: Duas áreas de vitiligo foram curetadas. Uma foi subseqüentemente enxertada com pele autóloga sacral normal, enquanto a outra não recebeu nenhum enxerto. As áreas curetadas foram examinadas após 30 dias, para avaliar o grau de repigmentação. A porcentagem de melanócitos e a presença de RNAm de tirosinase de pele normal e de pele de vitiligo (antes e após curetagem apenas e antes e após curetagem seguida de enxertia) foram comparadas.

RESULTADOS:: Repigmentação completa foi observada em todas as áreas enxertadas, enquanto as áreas de vitiligo apenas curetadas apresentaram repigmentação parcial. A porcentagem de melanócitos nas áreas enxertadas excederam as áreas de vitiligo não tratados (p = 0.01) e as áreas tratadas com curetagem simples (p = 0,015). RNAm de tirosinase foi negativo em 93.75% das áreas não tratadas de vitiligo. Após tratamento (somente curetagem ou curetagem seguida de enxerto), todas as lesões tornaram-se positivas para RNAm de tirosinase.

CONCLUSÃO:: Melanócitos metabolicamente inativos ou dormentes estão provavelmente presentes dentro das áreas de vitiligo, e podem ser ativados por estímulos endógenos ou exógenos.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. Normal skin graft procedure in curetted vitiligo area (marked inner square area).
Figure 2
Figure 2. Hyperpigmentation, 40 days after normal graft procedure in vitiligo area.
Figure 3
Figure 3. Polyacrylamide gel amplification of tyrosinase mRNA, detected via reverse transcriptase polymerase chain reaction (RT-PCR) 30 days after curettage of vitiligo.
See this image and copyright information in PMC

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