Vitiligo Treated With Novel Surgical Approach
Combining epidermal cell suspension (ECS) with follicular cell suspension (FCS) effectively improved repigmentation among patients with difficult-to-treat vitiligo, according to the findings of a recent study published in JAMA Dermatology.
The randomized trial included 30 patients who had stable vitiligo with symmetrical lesions (mean age 23.4 years, 60% women). The researchers prepared the ECS+FCS by mixing equal amounts of cells. Following manual dermabrasion, ECS+FCS was applied to 1 lesion and ECS was applied to anatomically based paired lesions on the same patient.
A blinded observer assessed the extent of repigmentation, color match, pattern of repigmentation, patient satisfaction, and complications at weeks 4, 8, and 16. Additionally, the researchers conducted visual and computerized image analyses to assess repigmentation outcomes. They used flow cytometry to assess cell suspensions for OCT4+ stem cell counts and used quantitative relative messenger RNA expression to evaluate the expression of stem cell factor and basic fibroblast growth factor.
Of the 84 treated lesions, 62 (74%) were classified as difficult-to-treat.
Compared with ECS, ECS+FCA showed superior extent of repigmentation (57% vs 76%, respectively), rapidity of repigmentation (31% vs 48%), and color match (61% vs 73%), as well as had higher patient satisfaction.
In addition, melanocyte stem cell counts, basic fibroblast growth factor, and stem cell factor were higher for lesions treated with the ECS-FCS suspension.
“This novel approach can be used in clinical practice for achieving optimal repigmentation in difficult-to-treat vitiligo and in scenarios with a demand for a quicker repigmentation outcome,” the researchers concluded.
Razmi TM, Kumar R, Rani S, Kumaran SM, Tanwar S, Parsad D. Combination of follicular and epidermal cell suspension as a novel surgical approach in difficult-to-treat vitiligo: a randomized clinical trial [published online January 31, 2018]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.5795.