Flip-top pigment transplantation: a novel transplantation procedure for the treatment of depigmentation.

Abstract

Cutaneous depigmentation afflicts millions of people worldwide. For example, vitiligo affects an estimated 1% of Americans' and 0.38% to 1.13% of individuals worldwide. 2 Although some patients may respond to treatment with topical corticosteroids or topical or oral psoralen plus UV-A (PUVA), 5 many do not, and therefore, they seek additional therapy. Several surgical procedures have been devised to repigment depigmented skin. 6 These include the transfer of autologous melanocytes derived from split-thickness skin grafts, 7 full-thickness skin grafts,8 punch grafts,9 pinch grafts, 10 or suction-induced blister roofs. 11 Autologous melanocytes have also been obtained from tissue cultures of melanocytes alone'2 or melanocytes plus keratinocytes. 13 Recipient sites may be prepared in a number of ways, including dermabrasion, 14 suction blisters, 15 liquid nitrogen-induced blisters, PUVA-induced blisters,'6 laser ablation, 17 or by removal of skin with a dermatome. 7 Some of these methods leave undesirable scarring (eg, cobblestoning), are time intensive, and/or require special equipment.