Noncultured Cell Research Articles

Treatment of stable vitiligo using cultured and non-cultured autologous melanocytes from hair follicle outer root sheath cell suspension

Background Several surgical treatment methods have been proposed for the treatment of stable vitiligo, but they remain inadequate in terms of patient satisfaction. Objective To assess the efficacy and safety of a modified autologous cultured hair follicle outer root sheath (HF-ORS) cell suspension transplantation in the treatment of stable vitiligo lesions, and to compare it with transplantation of autologous non-cultured HF-ORS cell suspension for the same patient. Patients and methods Twenty-four patients were enrolled in this prospective controlled study. Hairs were epilated, and HF-ORS cell suspensions were prepared using two methods for the same patient. The recipient site was prepared by CO2 laser resurfacing. Assessment of cellular activity and viability included cellular melanin content determined by enzyme-linked immunosorbent assay and measurement of the fold change in premelanosome (Pmel-17) gene expression. The patients were followed-up for 6 months postprocedure. Results Nineteen patients completed the study. The results demonstrated that the cultured method showed superior repigmentation response in 15 (79%) patients, three (16%) responded equally, and one (5%) was more tolerant of the noncultured method. Conclusion Cultured autologous HF-ORS melanocytes show superior repigmentation response, increased melanin content, and upregulated gene expression of Pmel-17 than that of noncultured ones. However, the study also demonstrated that both methods are potential options for the treatment of stable vitiligo.

A Comparative Study between Follicular Unit Transplantation and Autologous Non-cultured Non-trypsinized Epidermal Cells Grafting (Jodhpur Technique) in Stable Vitiligo.

Introduction:Several modalities are currently available for the treatment of vitiligo, but generally they do not result in complete cure of the disease. Despite the limitations and some side effects, surgical modalities appear to be the method of choice in recalcitrant stable vitiligo. Both Jodhpur technique (JT) and follicular unit transplantation (FUT) are simpler and cheaper methods, requiring minimal infrastructure.Materials and Methods:Hundred patches in 30 patients were divided into Group A and Group B, that is, hair follicle transplantation and autologous non-cultured non-trypsinized epidermal cell suspension grafting (JT), respectively. Fifty patches were included in each group. Efficacy of both the techniques, extent of pigmentation, and color match assessment were the main objectives.Results:Excellent repigmentation (>75%), at the end of 20 weeks post surgery, was observed in 70% lesions in FUT group and 72% of lesions in JT group. Good response (extent of repigmentation of 50%–75%) was seen in 18% of lesions in FUT group as compared to 26% in JT group. JT and FUT technique were almost equal in producing excellent repigmentation. Color match was same for both the groups, that is, 49 of 50 patches showed same color as surrounding in both groups at the end of 20 weeks. Repigmentation of the depigmented hairs occurred in 11 of 46 patients with associated leukotrichia.Conclusion:Our study indicates that both JT and FUT are safe and effective techniques in terms of repigmentation but JT is somewhat superior to FUT in producing excellent and good repigmentation, side effects, patient satisfaction, and dermatology life quality index reduction, while the color match was almost same with both techniques.

The clinical efficacy of treatment using the autologous non-cultured epidermal cell suspension technique for stable vitiligo in 41 patients

Background: Vitiligo is an acquired depigmentation skin disorder mainly caused by the destruction of melanocytes. There are many therapeutic options available for vitiligo, but the options are not uniformly effective.Objectives: This study aimed to explore the clinical effect of the autologous non-cultured epidermal cell suspension (NCES) technique in the treatment of patients with stable vitiligo.Methods: A retrospective study of before-after comparisons was undertaken with 41 patients with stable vitiligo who received treatment with the NCES technique. The percentage of repigmentation area was evaluated using image analysis of the appearance before and 6–9 months after operation.Results: A total of 41 patients (18 males and 23 females) with a duration of clinical stability for ranging from 1 to 10 years (mean 1.6 ± 1.9) were included. The mean age was 20.2 years (range, 8–50) and 4 (9.8%) were children under the age of 14 years. After 6–9 months of follow-up, 80.5% (33/41) of the patients showed good response; among these patients, 17.1% (7/41) showed complete or almost complete repigmentation. Interestingly, all 4 children showed very good response (more than 76% repigmentation). There were no significant differences in the efficacy of treatment between the different transplantation areas of the facial neck, trunk, and distal limbs and there were no adverse effects such as infection or scar formation.Limitation: This study included only a single center with a small sample size.Conclusions: Our study shows that the NCES technique has a high therapeutic effect, is safe for patients with stable vitiligo, and may be a very promising potential option for treating children.

Autologous non-cultured epidermal cell suspension combined with platelet rich fibrin for the treatment of stable vitiligo: A case series

Non-cultured epidermal cell suspension (NCECS) is a relatively new cellular grafting technique for vitiligo. Platelet rich fibrin (PRF) is a platelet and immune concentrate gather on a single fibrin membrane which can be used in conjunction with grafts and has several advantages, such as promoting wound healing, haemostasis, and give better handling properties to graft materials. This study was conducted to determine the efficacy of NCECS combined with PRF in patients with stable vitiligo. Seven patients with stable vitiligo which not responding to topical and phototherapy for more than 12 months were included in the study. The melanocytes were harvested as an autologous melanocyte rich suspension from a donor skin. The non cultured melanocyte transplanted to recipient area that had been superficially dermabraded and smeared with PRF gel. Of all 7 patients, 1 patients showed excellent pigmentation (90-100%), 2 had good repigmentation (60-89%), 1 had fair repigmentation (25-59%) and 3 patients had a poor response (0-24%). The procedure is safe and promising surgical modality for stable vitiligo.

Efficacy of Transplantation of Combination of Noncultured Dermal and Epidermal Cell Suspension vs Epidermal Cell Suspension Alone in Vitiligo

Surgical interventions, notably noncultured epidermal suspension (NCES), are the next line of treatment in patients with vitiligo who fail to respond to medical therapy. Noncultured epidermal suspension is usually performed in patients with vitiligo with duration of clinical stability (DS) of 12 months or longer because DS is a vital parameter in determining outcome of NCES. In this pilot study, we planned to assess the efficacy of a novel combination of noncultured epidermal cell suspension and noncultured dermal cell suspension (NCES and NDCS) in patients with vitiligo with shorter DS (3-6 months). To compare the efficacy of transplantation of NCES and NDCS vs NCES alone in patients with vitiligo with DS of 3 to 6 months. A single-center randomized clinical trial including 40 patients with focal, segmental, or generalized vitiligo with DS of 3 to 6 months or more than 12 months was carried out. Based on DS, 2 groups including 20 patients each were recruited (DS in group 1, 3 to 6 months; DS in group 2, more than 12 months). Each group was further randomized into 2 subgroups, A and B. Patients in subgroups 1A and 2A underwent NCES alone, whereas patients in subgroups 1B and 2B underwent NCES and NDCS. Extent of repigmentation, color match, and pattern of repigmentation at 24 weeks. Of the 40 study participants, mean (SD) age was 24.9 (4.0) years and 24 (60%) were women; in group 1 with DS for 3 to 6 months, more than 75% repigmentation at 24 weeks was observed in all 10 patients in subgroup 1B (NCES and NDCS) compared with 3 of 10 patients in subgroup 1A (NCES) (100% vs 30%, P = .003). In group 2 (DS > 12 months), the same was observed in 6 of 10 patients in subgroup 2A and 7 of 10 patients in subgroup 2B (NCES) (60% vs 70%, P > .99). The 2 groups and subgroups did not show any significant differences with respect to color matching and pattern of repigmentation. Combination of NCES and NDCS resulted in excellent response in patients with vitiligo with shorter duration of clinical stability compared with NCES alone. This combination may be used early in the course of stable vitiligo without waiting for a period of 12 months or more since last clinical activity. ClinicalTrials.gov identifier: NCT03013049.

Noncultured Extracted Hair Follicle Outer Root Sheath Cell Suspension versus Noncultured Epidermal Cell Suspension in the Treatment of Stable Vitiligo.

Background:Various treatment modalities exist for vitiligo, yet none of them are curative. Vitiligo is still considered a challenging disease to manage. Surgical treatment offers an excellent option for patients with stable vitiligo, especially those who fail to respond to medical treatment. Cell suspension techniques carry the advantage of covering large surface areas.Objective:To compare noncultured extracted hair follicle outer root sheath cell suspension (NCORSHFS) and noncultured epidermal cell suspension (NCES) in producing repigmentation.Subjects and Methods:Twenty patients were randomly allocated into two groups. They were objectively evaluated for the extent of repigmentation (after 1, 2, and 3 months), complications, cosmetic outcome, and satisfaction.Results:In NCORSHFS group, 10% showed excellent pigmentation, 20% showed good pigmentation, 50% fair, and 20% poor pigmentation. In NCES group, 10% showed excellent pigmentation, 10% good pigmentation, 40% fair, and 40% poor pigmentation. This difference was not statistically significant. Excellent color match was observed in 80% of NCORSHFS and in 70% of NCES. Donor area complications were absent in NCORSHFS group, whereas in NCES, mild scarring in 20% and hyperpigmentation in 40% of patients was observed. The difference in patients’ satisfaction between the two groups was not statistically significant.Conclusion:Both NCORSHFS and NCES are effective in producing good repigmentation with perfect color match and patients’ satisfaction. NCORSHFS has no donor area complications because it is a scarless procedure.

Safety and efficacy of autologous noncultured dermal cell suspension transplantation in the treatment of localized facial volume loss: A pilot study.

Available options for correction of facial volume loss, such as synthetic fillers, autologous fat and cultured fibroblasts, have limitations viz. temporary effect and high cost. To assess the use of a novel technique, autologous non-cultured dermal cell suspension transplantation, for correction of localized facial volume loss due to inflammatory pathologies. It was a pilot study conducted in the Dermatology Outpatient Department, All India Institute of Medical Sciences (AIIMS), New Delhi, India. Autologous non-cultured dermal cell suspension was transplanted in a total of 10 patients, out of which 5 had predominantly dermal loss and the rest had predominantly lipoatrophy. The donor tissue from the gluteal region was digested into a single cell suspension using collagenase-1 and injected into the recipient area. The outcome was assessed subjectively by patients and investigators and objectively using ultrasonography. Cell count, viability testing and measurement of mesenchymal stem cells were also done. On assessment of patients, the median improvement in the predominantly dermal atrophy group at 3 and 6 months was 70% (range: 10-90%) and 80% (range: 0-90%), respectively, and in the predominantly lipoatrophy group, 0% (range: 0-40) and 0% (range: 0-50), respectively. Mean thickness of dermis + subcutis at the baseline was 1.835 mm (range: 0.89-6.04 mm), which increased to 2.912 mm (range: 0.88-7.07 mm, P = 0.03) at 6 months. Our pilot study has some limitations such as small sample size and heterogeneity of the recruited patients. Autologous non-cultured dermal cell suspension transplantation appears to be safe and effective in localized facial dermal defects because of inflammatory pathologies, but not effective in deeper defects.

Comparative study of noncultured epidermal cell suspension and postage stamp skin grafting in stable vitiligo

Background: Vitiligo is an acquired primary depigmentary disorder, with a worldwide prevalence of 1%. Up to 80% of patients respond to medical treatment but for the rest of the patients, surgical methods are the treatment options. There is a scarcity of comparative studies of different surgical techniques in vitiligo. Aims: This article compares the efficacy of noncultured epidermal cell suspension (NCES) and postage stamp skin grafting in stable vitiligo. Methods: It was an experimental analytical study conducted over a period of 2 years. Two lesions in each patient were selected and those two lesions in each individual were randomized between Group A (NCES) and Group B (postage stamp grafting technique). Forty lesions in the 20 patients were divided into two groups − Groups A and B comprising of 20 lesions in each were taken up for surgery with two different procedures, that is, NCES and postage stamp grafting, respectively. Digital photographs were taken at every sitting. An analysis was performed using the Wilcoxon signed-rank test and Mann–Whitney tests and grading was done for response in the form of repigmentation as excellent (>75%), good (50%–75%), fair (25%–50%), and poor (<25%). Results: The patients included in the study belonged to different strata of society. Postage stamp split skin grafting being a simple and cost-effective technique showed excellent repigmentation in 19/20 (95%) of lesions as compared to NCES in which it was only seen in 13/20 (65%) lesions at the end of study over the period of 12 weeks. Conclusion: Postage stamp skin grafting is easy to perform, relatively inexpensive, and shows early and better results with minimum complications than NCES.

Intraepidermal injection of autologous non-cultured epidermal cell suspension in lesions of stable vitiligo: A novel method of repigmenting vitiligo

Background: Transplantation of autologous non-cultured epidermal cell suspension containing melanocytes (ANEM) is one of the well-known surgical options for repigmenting stable vitiligo lesions. The recipient site for transplantation has traditionally been prepared by dermabrasion, liquid N2, or laser resurfacing, which is costly, cumbersome and has risk of scarring. Objectives: The objectives of this study were to experiment a novel method of repigmenting stable vitiligo lesions by intraepidermal injection of ANEM in the vitiligo lesions. Materials and Methods: A total of 50 stable vitiligo lesions in 50 patients were included in the study. The prepared ANEM was inoculated intraepidermally in the lesions. Patients were given PUVASOL therapy in post-operative period and followed up 4 weekly for 24 weeks to see repigmentation. Results: At 24 weeks, pigmentation was seen in 31 (62%) lesions of 50 lesions. It was excellent in 6 (12%), good in 10 (20%), satisfactory in 8 (16%), and poor in 7 (14%) patients. Adverse events were mild and insignificant. Conclusion: Intraepidermal ANEM inoculation in stable vitiligo lesions is an effective, safe, and cheap dermatosurgical procedure.

A Study of Autologous Epidermal Non-cultured Cell Suspension in Stable Vitiligo Patients

Introduction To study the extent of repigmentation after autologous epidermal non-cultured cell suspension in stable vitiligo patients. Patients and Methods A prospective, longitudinal study was conducted to study the extent of repigmentation after autologous epidermal non-cultured cell suspension in 30 stable vitiligo patients Results By subjective assessment, 10% (3) patients showed poor response, 30% (9) showed good response and 60% (18) patients showed excellent response after follow-up at 6 months with good patient satisfaction. By objective assessment 10% (3) patients showed poor response, 13.3% (4) showed fair response and 23.3% (7) patients showed good response, 53.3% (16) patients showed excellent response after follow-up at 6 months. Extent of repigmentation was evaluated as-10% (3) showed poor response, 10% (3) showed fair response and 20% (6) patients showed good response, 60% (18) patients showed excellent response after follow-up at 6 months. Conclusion Autologous non-cultured epidermal cell suspension in stable vitiligo is a safe, effective, simple method, with superior quality of repigmentation.

A study of autologous epidermal non-cultured cell suspension in stable vitiligo patients

A study of autologous epidermal non-cultured cell suspension in stable vitiligo patients

Cell geteromorphism in the conditions of persistence of sapronoses causative agents in various environments.

The paper discusses the issues of morphofunctional variability of causative agents of sapronoses under stressful environmental conditions. In the current century, sapronoses infections attract more and more attention. Under unfavorable habitat conditions, their pathogens use a strategy for the formation of resting (stable) states: viable but non-cultured cell forms and the persistence of bacteria, which are characterized by reduced metabolism, changes in the morphology and physiology of microorganisms, and termination of their replication. With the formation of resistant forms of bacteria, the possibility of survival of sapronoses causative agents in the interepidemic period, the formation of their antibiotic resistance, which plays an important role in the chronicity of infections, is associated. The literature widely discusses the mechanisms and conditions for the formation of resistant states of pathogenic bacteria, their pathogenetic significance in infectious pathology, whereas the ultrastructural organization and morphological variability of resistant cellular forms, as well as their differentiation, causing the heterogeneity of the pathogens population, are not yet well covered. The emergence of molecular cell biology methods and the discovery of genetic modules of toxin-antitoxin systems revealed a single mechanism for regulating the formation of resistant cellular forms of bacteria. This served as the basis for the development of fundamentally new technologies for the study of the mechanisms for the conservation of the pathogenic potential of resistant cellular forms of pathogens of natural focal sapronosis in interepidemic periods. Based on the analysis of current data, as well as their own experience, the authors assess the role of morphofunctional changes in resistant cellular forms of bacteria and their significance in the adaptation strategies of causative agents of sapronoses (on the example of Yersinia pseudotuberculosis). The study of the manifestations of heteromorphism of causative agents of sapronoses forms the paradigm of the need to improve methods for detecting resistant forms of these bacteria in human and animal biomaterial in order to diagnose chronic recurrent and persistent infections, create effective strategies for monitoring and monitoring the environment.

Use of platelet-rich plasma to suspend noncultured epidermal cell suspension improves repigmentation after autologous transplantation in stable vitiligo: a double-blind randomized controlled trial.

Noncultured epidermal cell suspension (NCES) is an effective surgical modality for stable vitiligo which involves transplantation of the basal layer of epidermal cells onto the dermabraded vitiliginous patch. Platelet-rich plasma (PRP) has growth factors which may stimulate melanocyte migration and proliferation of keratinocytes and fibroblasts. The objective of this study was to compare the extent of repigmentation achieved by transplantation of NCES suspended in PRP with that of NCES suspended in phosphate buffered saline (PBS). Twenty-one patients of stable vitiligo with at least two lesions of comparable size were included. The two vitiligo patches were randomized to receive NCES suspended in PRP or PBS. Postoperatively after 1 week, patients were given heliotherapy for 15 minutes daily. At 6 months follow-up, mean repigmentation by area method in PRP arm was 75.6 ± 30% SD and in non-PRP arm was 65 ± 34% SD (P = 0.0036). Patient satisfaction by visual analogue scale at 6 months also showed better results in PRP arm (P = 0.001). Assessment by three independent observers showed better repigmentation in PRP side both at 3 and 6 months. Suspending NCES in PRP can result in significantly greater mean repigmentation and patient satisfaction than suspending in PBS.

Electrofulguration-assisted dermabrasion for recipient-site preparation in noncultured epidermal cell suspension type vitiligo surgery

Electrofulguration-assisted dermabrasion for recipient-site preparation in noncultured epidermal cell suspension type vitiligo surgery

Prise en charge des cicatrices hypopigmentées post-brûlure

Permanent hypopigmentation of burn scars is a common consequence after partial and full thickness burns that heal by secondary intent, and they can cause severe aesthetic issues. The surgical goals for effective treatment of postburn hypopigmentation are to remove scar tissues, and to produce healthy melanocytes, with minimal donor site morbidity. This article reviews the current literature about the different ways to treat hypopigmentation following burn injuries and discusses the indications. The PubMed database was searched for articles published from 1985 and up to 2016. Papers with regards to the management of hypopigmented lesions were included only if scars were following burn injuries. The treatments were assessed according to body region treated, surface involved, skin color, effectiveness on restoring skin pigmentation. Sixteen studies were included in this review. Non-surgical treatments like makeup and tattooing, and surgical treatments including thin skin grafting, chip skin grafting, punch grafting, non-cultured keratinocyte-melanocyte cell suspension, and cultured epidermal cells were all compared. Thin skin grafting is a reliable treatment especially for patient who suffer from small hypopigmented lesions as this method requires a donor skin of the same size. The cell suspension procedure may be beneficial for larger scars. Moreover demarcation between skin graft and normal skin may exist and when a precise color match is required, particularly in the head, tattooing and chip skin grafting produce a good pigmentation outcome.

Efficacy of Cyclosporine After Autologous Noncultured Melanocyte Transplantation in Localized Stable Vitiligo-A Pilot, Open Label, Comparative Study.

Understanding the pathogenesis of vitiligo has lead to innovation of new drugs and new uses of the existing drugs to enhance treatment outcome. The aim of this observational pilot study was to assess the role of cyclosporine (CsA) to tackle the commonest aesthetic problem "perilesional halo" after autologous noncultured melanocyte-keratinocyte cell transplant (NCMKT) for localized, stable vitiligo. Of the total 50 enrolled patients who underwent NCMKT for stable/resistant vitiligo, aged 12 to 68 years (mean 29.92 years), 18 were male and 32 were female. Group I (n = 25) patients did not receive any postoperative treatment. Group II (n = 25) patients received CsA postoperatively at 3 mg·kg·d for 3 weeks followed by 1.5 mg·kg·d for 6 weeks. In Group I, results were as follows: 28% (n = 7) achieved >75% repigmentation, 16% (n = 4) achieved 50% to 75% repigmentation, 52% (n = 13) achieved 25% to 50% repigmentation, and 4% (n = 1) achieved <25% repigmentation. In Group II, 100% (n = 25) achieved >75% (median 90.7%) repigmentation post-NCMKT at the end of 6 months. This new drug regimen using CsA resulted in rapid and uniform repigmentation without leaving any perilesional halo in Group II patients after NCMKT.

Evaluation of treatment response to autologous transplantation of noncultured melanocyte/keratinocyte cell suspension in patients with stable vitiligo.

BackgroundVitiligo is a chronic disease characterized by the appearance of achromic macules caused by melanocyte destruction. Surgical treatments with melanocyte transplantation can be used for stable vitiligo cases. ObjectivesTo evaluate treatment response to the autologous transplantation of noncultured epidermal cell suspension in patients with stable vitiligo.MethodsCase series study in patients with stable vitiligo submitted to noncultured epidermal cell suspension transplantation and evaluated at least once, between 3 and 6 months after the procedure, to observe repigmentation and possible adverse effects. The maximum follow-up period for some patients was 24 months.ResultsOf the 20 patients who underwent 24 procedures, 25% showed an excellent rate of repigmentation, 50% good repigmentation, 15% regular, and 10% poor response. The best results were observed in face and neck lesions, while the worst in extremity lesions (88% and 33% of satisfactory responses, respectively). Patients with segmental vitiligo had a better response (84%) compared to non-segmental ones (63%). As side effects were observed hyperpigmentation of the treated area and the appearance of Koebner phenomenon in the donor area.Study limitationsSome limitations of the study included the small number of patients, a subjective evaluation, and the lack of long-term follow-up on the results. CONCLUSION: Noncultured epidermal cell suspension transplantation is efficient and well tolerated for stable vitiligo treatment, especially for segmental vitiligo on the face and neck.

Rapid preparation of a noncultured skin cell suspension that promotes wound healing.

Autologous skin cell suspensions have been used for wound healing in patients with burns and against normal pigmentation in vitiligo. To separate cells and the extracellular matrix from skin tissue, most researchers use enzymatic digestion. Therefore, this process is difficult to perform during a routine surgical procedure. We aimed to prepare a suspension of noncultured autologous skin cells (NCSCs) using a tissue homogenizer as a new method instead of harsh biochemical reagents. The potential clinical applicability of NCSCs was analyzed using a nude-rat model of burn healing. After optimization of the homogenizer settings, cell viability ranged from 52 to 89%. Scanning electron microscopy showed evidence of keratinocyte-like cell morphology, and several growth factors, including epidermal growth factor and basic fibroblast growth factor, were present in the NCSCs. The rat model revealed that NCSCs accelerated skin regeneration. NCSCs could be generated using a tissue homogenizer for enhancement of wound healing in vivo. In the NCSC group of wounds, on day 7 of epithelialization, granulation was observed, whereas on day 14, there was a significant increase in skin adnexa regeneration as compared to the control group (PBS treatment; p<0.05). This study suggests that the proposed process is rapid and does not require the use of biochemical agents. Thus, we recommend a combination of surgical treatment with the new therapy for a burn as an effective method.

A retrospective study of 100 cases of focal vitiligo treated by autologous, noncultured melanocyte-keratinocyte cell transplantation

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span&gt;Vitiligo is a common skin disease affecting 1%-2% of general population. Even though different modalities of treatment available, it remains as a difficult disease to treat. Many cases remain stable after a period of medical therapy without any further response. Surgical techniques are the only hope in such patients.&lt;span class="apple-converted-space"&gt; The &lt;/span&gt;aim of this study was to evaluate the response of&lt;span class="apple-converted-space"&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/span&gt;autologous, noncultured melanocyte keratinocyte cell transplantation in patients with stable focal vitiligo&lt;/span&gt;&lt;span lang="EN-IN"&gt;.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span&gt;A retrospective study of 100 cases focal vitiligo treated by autologous, noncultured melanocyte-keratinocyte cell transplantation. Serial of photographs were taken on each visit. The patents were followed for a period of 5 years. The results were analyzed on a visual analogue scale&lt;/span&gt;.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span&gt;Out of total 100 patients, 44 had excellent (90 to 100%) response, 18 had good (60 to 89%) response, 12 had fair (25 to 59%) response and 26 had poor response (0 to 24%). Age and sex of the patients and size and duration of lesions, did not show significant influence on results of transplantation&lt;/span&gt;&lt;span lang="EN-IN"&gt;. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span&gt;This is a simple, safe, and effective surgical therapy for replenishing the missing melanocytes in resistant cases of vitiligo. Repigmentation lasts long with very good cosmetic acceptability&lt;/span&gt;&lt;span lang="EN-IN"&gt;.&lt;/span&gt;&lt;/p&gt;

Simplified Non-cultured Non-trypsinised Epidermal Cell Graft Technique Followed by Psoralen and Ultraviolet A Light Therapy for Stable Vitiligo.

Background and Aims:Stable vitiligo can be treated by various surgical procedures. Non-cultured melanocyte grafting techniques were developed to overcome the time-consuming process of culture while at the same time providing acceptable results. All the techniques using non-cultured melanocyte transfer involve trypsinisation as an integral step. Jodhpur technique used by the author is autologous, non-cultured, non-trypsinised, epidermal cell grafting.Settings and Design:The study was conducted on patients visiting the dermatology outpatient department of a tertiary health centre in Western Rajasthan.Materials and Methods:At the donor site, mupirocin ointment was applied and dermabrasion was done with the help of micromotor dermabrader till pinpoint bleeding was seen. The paste-like material obtained by this procedure containing melanocytes and keratinocytes admixed with the ointment base was harvested with spatula and was subsequently spread over the recipient area. Recipient site was prepared in the same manner by dermabrasion. After 10 days, dressing at both sites was removed taking utmost care at the recipient site as there was a theoretical risk of dislodging epidermal cells.Results:In a study of 437 vitiligo patches, more than 75% re-pigmentation (excellent improvement) was seen in 41% of the patches. Lesions on thigh (100%), face (75%) and trunk (50%) showed maximal excellent improvement, whereas patches on joints and acral areas did not show much improvement.Conclusions:This technique is a simplified, cost effective, less time-consuming alternative to other techniques which involve tryspsinisation of melanocytes and at the same time provides satisfactory uniform pigmentation.