Non-cultured Melanocyte Research Articles

Safety and Efficacy of Autologous Melanocyte/Keratinocyte Transplantation in Patients with Refractory Stable Vitiligo

Background: Vitiligo is a common depigmentation skin disease associated with significant psychosocial morbidity and profound effect on the quality of life. The treatment of vitiligo is still a major challenge in the field of dermatology. Currently, topical steroids, calcineurin inhibitors, ultraviolet phototherapy, surgery, and cultured and non-cultured epidermal melanocyte transplantation are used for the treatment of vitiligo. However, the effectiveness of these treatment modalities is limited by the lack of response, long-term treatment periods, high cost, and inevitable adverse effects. Objectives: In this study, we aimed to evaluate the efficacy of intraepidermal injection of autologous non-cultured melanocytes and keratinocytes as an alternative therapy for the refractory and stable (RS) vitiligo. Methods: The treatment procedure was performed on thirty-nine RS vitiligo patients. The autologous skin grafts obtained from the buttock area and epidermis were separated from dermis using dispase. Single-cell autologous melanocytes and keratinocytes were prepared from the epidermis by trypsin/ethylene diamine tetra acetic acid and injected at the concentration of 100–400 × 103 cells/cm2, intra-epidermally to the selected vitiligo lesions. Vitiligo re-pigmentation was monitored employing photography. Photographs were taken prior to and 2, 4, and 6 months after the cell transplantation. Improvement of the skin depigmentation was classified as follows: <25% as minimal response, 26–50% as moderate response, 51–75% as good response, and finally 76–100% as excellent response. Results: Cell infusion appeared to be safe as none of the patients exhibited any adverse effects. At the end of the sixth month follow-up period, of the treated patients, 12.8% demonstrated an excellent response, 36% exhibited a good response, and 51.2% showed a moderate to minimal response to the administered therapy. Obtained significant p value for Wilcoxon test over the checkpoints at 2nd, 4th, and 6th month (p = 0.03, 0.04, and 0.039, respectively) post-cell transplantation confirmed notable growing trend in the re-pigmentation. Conclusion: Our findings provide a strong support for the therapeutic efficacy of autologous non-cultured melanocytes and keratinocytes in patients with RS vitiligo.

A study on autologous non-cultured melanocyte transfer in patients of stable vitiligo at a tertiary care centre

Vitiligo is an acquired pigmentary disorder caused due to a loss of functional melanocytes. Autologous non-cultured melanocyte transfer (NCMT) is a recent surgical modality for the treatment of stable vitiligo.To evaluate the clinical outcome of NCMT in patients of stable vitiligo. Autologous melanocyte transfer was performed on 41 patients of stable vitiligo. They were evaluated at 1, 4, 12, 18 and 24 weeks post-surgery for extent for repigmentation and complications.In this study, the male- female ratio was nearly equal, with 51% males and 48% females the mean duration of stability of vitiligo lesion was 3.39 years. By 24 week of follow-up, 56.09% had excellent repigmentation (&amp;#62;90%), while 31.70% patients had good pigmentation (75-90%). No significant complications in donor area or recipient site were noted.Autologous non-cultured melanocyte transfer is a quick, single day procedure, and can be performed on an out-patient basis. It requires lesser technicalities than other surgical procedures for treating vitiligo and can prove to be an effective treatment modality in achieving homogenous repigmentation with an excellent degree of patient satisfaction.

New trends in the regenerative therapy of vitiligo. Literature review

Vitiligo is the most common acquired skin depigmentation disorder characterized by progressive loss of pigmentation caused by the destruction of functional melanocytes in the epidermis. The pathogenesis consists in the interaction of genetic components, metabolic factors associated with cellular oxidative stress, adhesion of melanocytes to the epithelium and autoimmunity, which culminate in aggression against melanocytes. To date, the treatment of vitiligo, according to Russian and European clinical guidelines, consists in the appointment of various drug and non-drug methods: the use of topical and systemic glucocorticosteroids, calcineurin inhibitors, azathioprine, phototherapy, both in the form of monotherapy and their combination.&#x0D; In recent years, in connection with the development of cellular technologies, alternative methods of therapy based on the transplantation of autologous cultured and non-cultured melanocytes have become widespread in the treatment of vitiligo. The most promising options for vitiligo cell therapy are methods based not only on the transplantation of ready-made cellular structures, but also on the replacement of damaged cells with a transplant of pluropotent progenitor stem cells or their immature committed structures.&#x0D; This article is of an overview nature. The aim of the review is to update information on promising new treatments for vitiligo. A literature review was conducted using the PubMed, Cochrane Library, CyberLeninka and Internet databases to study clinical and preclinical data on the possibility of using innovative methods of regenerative medicine in patients with vitiligo.&#x0D; This review is addressed to medical researchers interested in the treatment of vitiligo.

The story of melanocyte: a long way from bench to bedside.

Skin is composed of major layers, namely a superficial epidermis and a deeper dermis. The color of skin is influenced by a number of pigments, including melanin, which is produced by cells called melanocytes. Most skin disorders are relatively benign, but a few, including melanomas, can be fatal. A number of more noticeable disorders, namely albinism and vitiligo, affect the appearance of the skin and its accessory organs. Vitiligo is associated with significant psycho-social morbidity and a major effect on quality of life. Topical steroids, calcineurin inhibitors, phototherapy and surgery are the most common treatments for melanoma. However, there are many patients who do not respond to any of these modalities. The transplantation of cultured or non-cultured melanocyte is the most important treatment for hypopigmentory disorders. This study aims at reviewing the history of melanocyte cultivation, and evaluating the effectiveness of transplantation of cultured cells. For this purpose, the authors examined the initial process of isolation, characterization, and transplantation of epidermal cells. This review, thus, summarizes the current understanding of the cutaneous pigmentary system from the start of synthesis in the pigment cells, along with the response of repigmentation. During the production of melanin, melanosomes are transferred to neighboring keratinocyte in order to form perinuclear melanin caps. The objective of this review is to analyze the melanocytes transplantation in the last century to date, and explore the methods epidermal cells can increase pigmentation in hypo-pigmented areas in skin disorders. Moreover, the focus is on the story of the melanocyte back to 1950s. In addition, prior systemic therapy was associated with a significant increase, based on combined additional therapy, achieving desired results and improved outcomes. Despite the short study of a long way of melanocyte assessment and following up patient treatment, results of the all reports confirmed the efficacy of the method used in the treatment of stable vitiligo patients, who did not respond to the common algorithms of non-invasive treatments.

A 4-year follow-up study of 20 cases of stable localized childhood vitiligo treated by autologous, noncultured melanocyte–keratinocyte cell transplantation

Background: Vitiligo is a common skin disease affecting 1% to 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. For treating pediatric vitiligo, currently available and result providing therapies are limited. Surgical techniques are the only hope in such patients. Only limited studies are available regarding surgical interventions in childhood vitiligo. Aim: To evaluate the response of autologous, noncultured melanocyte–keratinocyte cell transplantation in childhood stable vitiligo. Methods: A retrospective analysis was conducted in 20 cases of stable localized childhood vitiligo (10 segmental and 10 focal) treated by autologous, noncultured melanocyte–keratinocyte cell transplantation. Serial photographs were taken from the first visit onwards. The patients were followed for a period of 4 years. The results were analyzed on a visual analog scale. Results: Out of total 20 cases, 11 had excellent (90–100%) response, 4 had good (60–89%), 2 had fair (25–59%), and 3 had poor response (0–24%). Age and sex of the patients and size and duration of lesions did not show significant influence on results of transplantation. Conclusion: This is a simple, safe, and effective surgical therapy for replenishing the missing melanocytes even in resistant cases of vitiligo. Only limited studies are there in childhood vitiligo. In spite of its invasive nature, it can be used to treat localized stable vitiligo in children.

A Study to Compare Efficacy of Non Cultured Autologus Melanocyte Transfer Versus Punch Grafting Technique for Stable Vitiligo Patients

Background: Vitiligo is a common acquired idiopathic hypomelanosis, which is characterized by loss of melanocytes in the epidermis associated with autoimmune and hereditary causes. The various surgical modalities available are tissue grafting techniques such as punch grafts, suction blister grafts, and split-thickness grafts as well as cellular grafts such as autologous noncultured epidermal cell suspensions and cultured melanocyte suspensions. Objective: We aimed to study and compare the efficacy of noncultured melanocyte transfer technique and punch grafting technique in the management of stable vitiligo. Materials and Methods: Fifty patients of both sexes between the ages of 15 and 50 years having stable vitiligo for minimum 1 year were included in the study and divided in two groups. Group 1 was treated with autologous noncultured melanocyte-rich cell suspension and Group 2 was treated by punch grafting technique. Response to treatment was evaluated on the basis of degree of repigmentation (both subjective and objective assessment), which was carried out at monthly intervals for a period of 6 months along with clinical photographs. Results: The results were statistically analyzed using “Chi-square test” and “statistical significance” (p-value) methods. An excellent (&gt;75% repigmentation) result was obtained in 77.27% of patients by NCMT (noncultured melanocyte transfer) technique whereas good (60%–75% repigmentation) result was obtained in 78.57% of patients by punch grafting technique after 6 months. Conclusion: Noncultured melanocyte transfer is a simple and effective technique to produce uniform pigmentation in short duration and is suitable to cover large body surface areas with a cosmetically better outcome and is better than punch grafting.

Review. The story of melanocyte: long way from bench to bedside

Skin is composed of major layers, a superficial epidermis and a deeper dermis. The color of skin is influenced by a number of pigments, including melanin. Melanin is produced by cells called melanocytes. Most skin disorders are relatively benign, but a few, including melanomas, can be fatal. A couple of the more noticeable disorders, namely albinism and vitiligo, affect the appearance of the skin and its accessory organs. Vitiligo is associated with significant psychosocial morbidity and profound effect on quality of life. Topical steroids, calcineurin inhibitors, phototherapy and surgery are most common treatments. However, there are many patients who do not respond to any of these modalities. The transplantation of cultured or non-cultured melanocyte is the most important treatment for hypopigmentory disorders. In this study, we are going to assess the history of melanocyte cultivation and evaluate the effectiveness of transplantation cultured cells. We examined the beginning process of isolation, characterization, and transplantation of epidermal cells. This review, summarize our current understanding of the cutaneous pigmentary system from the start of synthesis in the pigment cells, along with the response of repigmentation. During the production of melanin, melanosomes are transferred to neighboring keratinocyte in order to form perinuclear melanin caps. The objective of this review is to analyze the melanocytes transplantation in the last century up to now, and how epidermal cells can increase pigmentation in hypo-pigmented areas in skin disorders. Also, we focus on the story of the melanocyte back to 1950. In addition, prior systemic therapy was associated with a significant increase significant increase based on combined additional therapy, achieving desired results and improved outcomes. Despite the short study of a long way of melanocyte assessment and follow up patient's treatment, results of the all reports were confirmed the efficacy of the used method in the treatment of stable vitiligo who did not respond to the common algorithms of non-invasive treatments.

Risk Factors for Infection After Noncultured Melanocyte Keratinocyte Transplantation for Vitiligo.

Noncultured autologous melanocyte keratinocyte transplantation is considered a safe and effective treatment option in stable vitiligo. Factors associated with risk of infection are still poorly explored. To search for factors associated with the risk of infection after noncultured autologous melanocyte keratinocyte transplantation (MKTP). This was a retrospective multicentric study including all patients with vitiligo who had undergone noncultured autologous MKTP between January 2010 and December 2020. Data included age, sex, site, and size of the treated area, recipient area preparation method, and antibiotic prescription preceding the procedure. Univariate and multivariate analyses to search for factors associated with infection after MKTP were conducted. A total of 672 patients were included. Infection was present in 39 of the patients (6%) (95% confidence interval [CI]: 4.2%-7.7%). The following factors were independently associated with higher rate of infection: cryotherapy for recipient area preparation (OR 19.76, 95% CI: 3.21-121.74) and treated lesions on the trunk (OR 2.67, 95% CI: 1.21-5.90), lower extremity (OR 5.99, 95% CI: 2.49-14.40), and foot (OR 13.15, 95% CI: 4.37-39.62). Infection after noncultured autologous MKTP is not uncommon. Cryotherapy for recipient area preparation and lesions on the trunk, lower extremity, or foot was independently associated with an increased risk of infection.

Comparison of micro skin grafting and transplantation of non-cultured melanocyte keratinocyte suspension for the treatment of stable vitiligo: A pilot study

Objectives: We conducted this pilot study to compare the outcomes of non-cultured epidermal suspension (NCES) with that of micro skin grafting (MSG) in the treatment of stable vitiligo Material and Methods: Twenty-nine patients with clinically stable vitiligo lesions (defined as the occurrence of no new lesions and no increase in the size of preexisting lesions for the past six months) and age group between 12 and 70 years were enrolled in the study. The enrolled patients were randomized into two groups using simple randomization using computer-generated random numbers, and allocation concealment was done using opaque sealed envelopes. Group 1 was comprised of 15 patients with 23 stable vitiligo lesions, and group 2 comprised of 14 patients with 22 stable vitiligo lesions. Patients in group 1 were transplanted with non-cultured melanocytes and keratinocytes. Patients in group 2 were treated using micro skin grafts after obtaining written informed consent. Ethical clearance was obtained from the Institute ethics committee, and the principles of the 1975 Declaration of Helsinki were followed. Results: At the end of four months post-treatment, two patients (one in each group) did not follow up after removal of dressing at the first week. Results were analyzed at four months in 27 patients – 14 patients with 22 lesions in group 1 and 13 patients with 21 lesions in group 2. Repigmentation at 16 weeks post-surgery was evaluated. Excellent repigmentation (&gt;90%) was seen in 45.45% of lesions in the non-cultured epidermal suspension (NCES) group as compared to 38.09% of lesions in the micro skin grafting (MSG) group, and this difference was not statistically significant (p = 0.7597). Repigmentation &gt; 75% was achieved in 54.54% of lesions in the non-cultured epidermal suspension (NCES) group compared to 38.09% of lesions in the micro skin grafting (MSG) group, and this difference was not statistically significant (p = 0.3640). Both the groups did not have any significant complications like scarring, milia, or any cobble stoning at the donor site. The recipient area had resistance to the spread of pigment at the margins of lesions. Six lesions in both the groups with excellent response, 3 in each group had achromic fissure or hypopigmented halos at the margins of lesions. Conclusion: Both non-cultured epidermal suspension (NCES) and micro skin grafting (MSG) have been found to be safe and effective modalities with comparable efficacy in the surgical treatment of stable vitiligo. However, future trials on large sample sizes are warranted to validate our results.

A comparative study of efficacy of split-thickness skin grafting versus autologous melanocyte transfer in the management of stable vitiligo

BackgroundVitiligo is a depigmenting skin disorder resulting from the loss of melanocytes in the epidermis. Surgical treatment is indicated in resistant stable vitiligo that does not show adequate response to medical therapy. This study aims at comparing the efficacy of repigmentation by split-thickness skin grafting (STSG) versus autologous non-cultured melanocyte transfer (AMT) in the management of stable vitiligo. MethodsA total of 22 patients were recruited, which included 100 stable vitiligo patches. Fifty patches were subjected to STSG, and the remaining 50 were subjected to AMT. The patients were followed up at monthly intervals for six months to assess the degree of repigmentation. ResultsThe results at the end of six months were as follows: 40% patches in group A and 42.5% in group B exhibited >75% repigmentation. The outcome was better over the limbs, acral parts and joints. The average donor-to-recipient area ratio for group A was 1:1, whereas that for group B was 1:3.2. ConclusionBoth STSG and AMT are effective surgical modalities in the management of stable vitiligo. However, AMT has cosmetically better good outcomes, requires a smaller size of the donor area and has minimal complications over both recipient and donor areas.

Outcomes of autologous non-cultured melanocyte keratinocyte transplantation in vitiligo and nevus depigmentosus

Background Melanocyte-keratinocyte transplantation procedure (MKTP) is an effective surgical technique for restoring skin pigmentation in all types of vitiligo and leukoderma patients who are unresponsive to medical and/or phototherapy treatment. Data specific to the outcomes of MKTP among Thai vitiligo and nevus depigmentosus patients are currently scarce. Objectives To evaluate the efficacy and safety of MKTP in patients with vitiligo or nevus depigmentosus at the short-term (≤6 months) and long-term (≥12 months) follow-up. Materials and methods A retrospective review of the medical records of vitiligo or nevus depigmentosus patients who underwent MKTP at the Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during 2016 to 2019 was conducted. Repigmentation outcomes were evaluated by Vitiligo Area Scoring Index (VASI). Results Twenty-five patients had 27 MKTP surgeries on 32 anatomically-based lesions. The mean age was 32.4 years, the mean age at onset was 25.5 years, and 19 patients were male. Segmental vitiligo, non-segmental vitiligo, and nevus depigmentosus had significantly improved VASI scores at the short-term follow-up (−74.2% ± 23.2%, −100%, and −62.5% ± 17.6%, respectively) and the long-term follow-up (−81% ± 27.7%, −95.0% ± 7.0%, and −83.3% ± 14.4%, respectively). Conclusion MKTP is a safe and effective method for treating refractory vitiligo and nevus depigmentosus in Thai patients.

One-Year Follow-Up of Vitiligo Patients Treated with Autologous Non-Cultured Melanocytes

Background: Vitiligo is a long-term multifactorial polygenic disorder, characterized by the patchy loss of pigments in the skin. Several treatments including therapeutic creams and oral drugs are used to treat vitiligo with varying degrees of success. Some medical treatments can reduce the severity of the disease, but it is difficult to cure the disorder. Autologous non-cultured melanocyte transplantation is an effective method of vitiligo treatment. The utilization of appropriate cell suspension is a safe and efficient strategy to cure such hypopigmentation disorder. Objectives: The aim of this study was to follow up patients suffering from generalized and stable vitiligo who were treated with transplanted cells. Patients with patches in four different parts (forehead, eyelids, trunks, and hands) were selected because skin thickness varied among different body parts. We compared melanin repigmentation in these areas. Methods: We recruited 39 patients with generalized and stable vitiligo who had patches on their forehead, eyelids, trunks, and hands. Partial grafts were taken from the gluteal regions of all patients. Epidermal cells including non-cultured melanocyte and keratinocyte suspensions were enzymatically isolated and found to be of > 98% viability. Cells were injected intraepidemally. After a 12-month follow-up, repigmentation was observed. Results: The mean repigmentation score continued to improve up to 12 months post-transplantation. The obtained results confirmed that the cellular suspension that consisted of a mixture of epidermal cells improved to restore the normal color of the repigmentation rate. The number of received cells per cm2 positively influenced the repigmentation score. Patches located on the face, neck, and trunk areas showed significantly higher responses to treatment. The pigmentation score was classified as “poor” (1% - 25%), “moderate” (26% - 50%), and “good” (51% - 75%). This study is a research and clinical study with a brief report registered with the Ethics Committee of Avicenna Research Institute, clinical trials (letter number: 93/22/01/89), Tehran, Iran. Conclusions: The application of autologous non-cultured melanocyte-keratinocyte cell suspension could restore the patchy skin color to a near-normal level and the majority of the patients were satisfied with the results.

A prospective observational study of follicular unit excision grafting for the management of stable vitiligo

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Vitiligo is a common acquired idiopathic and often, familial hypomelanosis, which is characterized by pale white macules that enlarges centrifugally over time. In India, vitiligo is associated with marked social stigma, thus demanding its effective management. Stable vitiligo lesions known to be relatively refractory medical therapy require surgical therapies like skin grafting or grafting of invitro cultured and non-cultured melanocytes or follicular unit excision (FUE) grafting.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective observational study was done on patients of stable vitiligo. A total of 20 patients were enrolled and underwent FUE grafting for study of effectiveness and complication.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A total of 20 patients of stable vitiligo were studied with or without leukotrichia in which good to excellent response was seen in 13 (65%), fair in 6 (30%) and poor in 1 (5%) patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; FUE is a superior and upcoming methodology which is cost effective, reliable, less disfiguring, very low morbidity and results in good color match in patients with stable vitiligo.&lt;/p&gt;

Non-cultured melanocyte transfer in the management of stable vitiligo.

Background and Aims:Present study aimed to determine the clinical outcome for non-cultured melanocyte transfer in the management of stable vitiligo.Methods:A hospital based prospective study was conducted including 50 stable unresponsive patients of vitiligo undergoing non-cultured melanocyte transplant. Re-pigmentation was analyzed on the basis of baseline photographs after 6 months post procedure. Degree of re-pigmentation was estimated to the nearest of one of the following percentages and the final outcome of re-pigmentation for statistical analysis was graded as: >70% re-pigmentation: Good; 30-69% re-pigmentation: Fair and; <30% re-pigmentation: Poor.Results:The mean age of study group was 29.79 ± 13.8 with 52% males and 48% females. Out of total 50 patients, 31 (62%) patients showed good re-pigmentation, 10 (20%) showed fair re-pigmentation while 9 (18%) patients showed poor re-pigmentation. Patches over face, lips, trunk and legs showed good re-pigmentation, however patches over acral areas and bony prominences had poor re-pigmentation.Conclusion:Autologous non-cultured melanocyte transfer have an edge over the other modalities, however, proper patient selection, proper technique and good laboratory set up is required. It has an advantage over conventional split skin thickness grafting as it requires very little donor site skin.

Autologous non-cultured melanocyte-keratinocyte transplantation in the treatment of vitiligo: patient selection and perspectives.

Autologous non-cultured melanocyte–keratinocyte transplantation procedure (MKTP) is one of the simplest cellular grafting techniques. Various modifications were done over the years to make the technique easier and more economical which led to its great popularity among dermatologists. Proper patient selection and good technical skills are essential for achieving success with this technique. In this review, different patient-related and procedure-related factors that affect the outcome are discussed. This review may guide dermatologists to select suitable candidates, and explains what to expect in each case and indicates different techniques which can be used. The expected complications and stability of acquired pigmentation, which are an essential part of the pretreatment patient counseling, are also discussed.

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.

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.

Some modifications in transplantation of autologus non -cultured melanocytes-keratinocytes suspension in treatment of segmental and focal vitiligo (Egyptian Experience in Alexandria University)

Introduction: Transplantation of Autologous non-cultured melanocytes suspension is a simple yet effective cell-based therapy for vitiligo. Materials and Methods: 20 patients with stable vitiligo were subjected to epidermal cell suspension transplantation using Osslon’s method with some new modifications. Result: The repigmentation at 7 of the test sites (35.0%) was excellent. It was good for more than half of the test sites (55.0%). Fair repigmentation was encountered among only 2 (10.0%) of the tested sites. None of the tested sites showed poor repigmentation. On the other hand, none of the control sites showed excellent or even good repigmentation. However, repigmentation was fair for nearly 10% and it was poor for 90% of the control sites. Conclusion: Autologus non cultured basal -enriched epidermal cell suspension transplantation is an effective, simple and safe method for treatment of stable vitiligo.

Non-cultured epidermal suspension in vitiligo: From laboratory to clinic

Medical treatments are ineffective in many patients and surgical methods have therefore been developed. A review of autologous non-cultured melanocyte grafting techniques is proposed to obtain a successful repigmentation of vitiligo macules. Initially in 1992, we had developed a simplified grafting method which was carried out in the following two steps: production of blisters on the depigmented lesions by freezing with liquid nitrogen and injection in each blister of a non-cultured suspension of epidermal cells. The cellular suspension was obtained from samples of skin of the hair scalp after trypsinization. This very simple technique could be used at the dermatologist's clinic. Since 1998 (Olsson MJ, Juhlin L), quite comparable but improved and more sophisticated techniques have been proposed for the surgical treatment of vitiligo. These techniques require a laboratory set up to perform the melanocyte transplantation. The donor zone was usually taken on the gluteal region. The time of trypsinization was reduced to 60 minutes at 37°C and the centrifuged cellular suspension added with hyaluronic acid (Van Geel) was directly applied on a dermabraded or laser abraded vitiligo lesions. Whatever the technique chosen, repigmentation was evident within 25 to 30 days. Coalescence of the pigmented areas was spontaneously observed or obtained after UVB radiation. It is obvious that the complete repigmentation occurred more rapidly with the recent techniques compared with the initial method, but the efficiency was quite similar. The use of non-cultured epidermal suspension appears to be an effective, safe, and simple method for treating patients with achromic areas lacking melanocytes.