Preparation of Recipient Areas When Skin Grafting for Camouflage of Static Localised Vitiligo

Abstract

SummaryA prospective randomized study was undertaken in 50 patients with static localised vitiligo to determine the optimum thickness of the excision of patches of vitiligo prior to grafting with normally pigmented very thin split-thickness skin grafts.Recipient areas (diseased skin) were prepared in 1 of 5 different ways (n = 10 per group): Group 1, dermabrasion of epidermis alone; Group 2, shaving of thin partial-thickness skin; Group 3, shaving of medium partial-thickness skin; Group 4, excision of full-thickness skin alone and Group 5, excision of full-thickness skin with subcutaneous fat.After a minimum follow up of 6 months, results showed that in Groups 1 and 2, the skin grafts desquamated by the re-growth of epidermis from the recipient bed. In the Group 3, grafts were unsightly because of retention cysts and a prominent edge. In Group 5, grafts became hyper-pigmented and the grafted area was scalloped. Optimum results were obtained in Group 4 with best aesthetic appearance. Vitiligo patches are best treated by excision of full-thickness skin when resurfacing with normally pigmented thin split-thickness skin grafts.