Repigmentation by autologous melanocyte transplantation is a possible vitiligo cure in patients with focal or segmental vitiligo.
What is repigmentation by autologous melanocyte transplantation?
In this procedure for vitiligo cure, the normal melanocytes of the patient are harvested from his own normal skin, cultured in a medium and transferred to grow on the vitiligo affected area of skin.In this repigmentation procedure there is least chance for the rejection of the transplanted melanocytes by his skin and complete cure can be achieved.
Patient's suitability for achieving vitiligo cure with repigmentation by autologous melanocyte transplantation
Not all vitiligo patients can get cure from this repigmentation surgery.In active and progressive vitiligo, cure cannot be contemplated as fresh areas of skin keep losing melanocytes.
If the vitiligo is stable and nonprogressive for more than a year then this procedure of autologous melanocyte transplantation can be considered.
Vitiligo cure is possible with repigmentation by autologous transplantation in patients with focal or segmental vitiligo.
The affected area of skin must not be extensive as normal donor skin is required for the culture of the melanocytes transplantation.
In patients with Koebner phenomenon, vitiligo cure is not possible as linear depigmentation may start after the autologous transplantation.
Patients with keloid tendency and collagen disorder cannot undergo autologous repigmentation for cure of vitiligo, as keloid scars can develop at the sites of autologous melanocyte transplantation.
Patients with infections, especially of skin have to be treated and totally free of the ailment to be considered for this vitiligo cure.
In this melanocyte transplantation for repigmentation, a strict selection of the candidates for the procedure and a long pretreatment observation is necessary to prevent failures.
Surgical procedure for achieving vitiligo cure with repigmentation by autologous transplantation
After anaesthetising the donor skin area of the patient a thin layer of 5-10 sq.cm of epidermis layer of skin is removed (excellent results with silver skin graft knife).Care must be taken not injure the dermis, as injury to the dermis can cause scars at the donor site.
Alternatively an electric vacuum suction pump can be used to cause a blister at the donor skin area and the top of the blister is removed.
This epidermis layer is incubated for about one hour in trypsin and if any pieces dermis present is separated from the epidermis.
The epidermis is made into very small pieces and kept in the culture medium for further growth before the autologous melanocytes transplantation.
The culture is centrifuged to separate out the melanocytes.
Alternatively the separated melanocytes can be directly transplanted without further culture.
The vitiligo patch is prepared for autologous transplantation surgery and local anaesthesia is given.
Dermabrasion is done with laser or micromotor and the epidermis is removed.
Care must be taken not to injure dermis layer as injury to dermis may cause scars and cure by autologous repigmentation can get affected.
After the removal of epidermis, the melanocyte suspension is uniformly applied over the exposed dermis layer and the wound is covered with dressing of collagen.
The dressing is removed after a week. The treated patch may appear pink when the dressing is removed.
In about a month, repigmentation will start. The repigmentation covers up the entire area in four months.
In some patients another visit is required for achieving 100% pigmentation and cure.
Advantages of vitiligo cure with repigmentation by autologous transplantation
For vitiligo cure with autologous repigmentation hospitalization is not required.In most of the cases near 100% results are seen.
Autologous repigmentation can be done on any area of the body.
Larger areas can be covered with melanocyte transplantation with small patches of epidermis; Aesthetic appearance is regained.
Normally no scars are caused in vitiligo cure with repigmentation by autologous melanocyte transplantation.