Depigmentation during vitiligo activity spares epithelial grafted areas

Abstract

Background: Vitiligo is a depigmenting disease characterized by episodes of stability and activity without a fixed sequence, and active phases demonstrate immune attacks toward vulnerable melanocytes. Epithelial grafts were introduced to treat recalcitrant vitiligo patches aiming to provide new generations of melanocytes.

Aims: The aim of study was to evaluate the possible permanency of succeeded epithelial grafts during a coming activity episode.

Methods: This study included 20 nonsegmental vitiligo cases. They were epithelial grafted, success was maintained with the use of UV sessions for a year, and further follow-up was allowed until new phases of activity developed.

Results: The grafted areas, in all cases, were spared during the activity episodes in spite of the development of new depigmented lesions in other parts of skin neighboring the grafted areas or in remote sites.

Conclusion: The permanency of epithelial grafts in spite of disease reactivity is a good sign and magnifies the value of surgical approaches in management of vitiligo. New genetically different melanocytes should have been provided and were able to resist the new immune attacks in spite of the yielding of other skin melanocytes.

Keywords: activity phases; depigmentation; epithelial grafts; immune reaction; surgical approaches; vitiligo.