Melanocyte-keratinocyte transplantation procedure in the treatment of vitiligo: the experience of an academic medical center in the United States

J Am Acad Dermatol. 2012 May;66(5):785-93. doi: 10.1016/j.jaad.2011.05.002. Epub 2011 Aug 23.

Abstract

Background: Vitiligo is a disfiguring disease with limited treatment options. Surgical treatment is underused in the United States because of perceived risk of infection, costs, and difficulty of the procedure.

Objective: We sought to determine the efficacy and safety of the melanocyte-keratinocyte transplantation procedure (MKTP) in an academic dermatology department in the United States.

Methods: This prospective, uncontrolled, open-label study enrolled patients aged 18 years or older with a self-reported history of vitiligo and no new or expanding lesions for at least 6 months before surgery. Patients with a history of koebnerization or keloid formation were excluded. Patients underwent autologous MKTP. Repigmentation during a 3- to 6-month follow-up period was assessed categorically and by modified Vitiligo Area Scoring Index. Safety was assessed by frequency of adverse events.

Results: Of the 28 patients who underwent 36 procedures, 23 patients who underwent 29 procedures completed the 3- to 6-month follow-up period. Data for these 29 procedures show excellent repigmentation (ie, 95%-100%) after the MKTP in 17%, and good repigmentation (ie, 65%-94%) in 31%. Fair (64%-25%) and poor (24%-0%) repigmentation were achieved in 10% and 41% of patients, respectively. Average percent change in Vitiligo Area Scoring Index was -45% (95% confidence interval -64% to -26%), signifying an improvement in pigmentation.

Limitations: Limitations include small sample size and lack of a control group.

Conclusions: The MKTP is an effective and well-tolerated procedure based upon categorical and Vitiligo Area Scoring Index assessments of repigmentation.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Academic Medical Centers
  • Adolescent
  • Adult
  • Cell Transplantation / adverse effects
  • Cell Transplantation / methods
  • Esthetics
  • Female
  • Follow-Up Studies
  • Graft Rejection
  • Graft Survival
  • Humans
  • Keratinocytes / transplantation*
  • Male
  • Melanocytes / transplantation*
  • Middle Aged
  • Prospective Studies
  • Risk Assessment
  • Transplantation, Autologous
  • Treatment Outcome
  • United States
  • Vitiligo / diagnosis
  • Vitiligo / surgery*
  • Young Adult