Cultured autologus epithelia grafting for treating vitiligo: Results in 5 cases

Vitiligo, which is histologically characterized by the absence of epidermal melanocytes, is manifested as irregular depigmented macules of the skin that can vary in size from minute to large in any area of the body. Patients with vitiligo are mainly treated with psoralens and ultraviolet A (PUVA) or corticosteroids, singly or in combination, but the results of these therapies are occassionally disappointing and, for some cases, ineffective. Thus, in the search for better vitiligo therapies, clinical trials have been conducted using autografts, such as a punch graft, minigrafts, or an epidermal graft, and while these grafts have induced skin repigmentation, the appearance is often uneven and spotty and flawed by unsightly scarring. To avoid scarring, we have tried another approach using cultured autologus epithelia grafting, first reported by Todd in 1989, in 5 patients with vitiligo and have achieved considerable repigmentation, ranging from 30 to 95% of the graft. The reason for this pigmentation inconsistency is thought due to the state of the vitiligo, which in some patients was still active. We thus have concluded that cultured autologus epithelia transplantation may hold promise as a treatment method for patients with inactive vitiligo.