Usefulness of Micro-Punch Skin Grafting for Treatment of Resistant Vitiligo

Samy, Aya; El-Sabbagh, Ahmed; Mohamed, Adel; Abdel-Halim, Mostafa M.

doi:10.21608/ejprs.2022.220420

Usefulness of Micro-Punch Skin Grafting for Treatment of Resistant Vitiligo

Document Type : Original Article

Authors

¹ Plastic surgery department, Mansoura university, Mansoura, Egypt

² The Department of Plastic Surgery, Faculty of Medicine, Mansoura University

³ The Department of General Surgery, Faculty of Medicine, Mansoura University

⁴ The Department of Plastic Surgery , Faculty of Medicine, Mansoura University

10.21608/ejprs.2022.220420

Abstract

Introduction: Vitiligo is a depigmented common skin
disorder. The disease may lead to social and psychological
distress to the patient. Therefore, a good treatment can improve
the patient's life quality. Punch grafting is a simple and
commonly used method of treating vitiligo. However, it is
time consuming with the risk of post-operative cobble stoning
appearance. We used motorized 0.8-1.3 micro-punch grafting
procedure to overcome these limitations.
Aim: To evaluate the therapeutic effectiveness of using
micro-punch grafting to treat vitiligo and adverse events
associated with this method.
Patients and Methods: This is a prospective study for 20
patients with vitiligo. They underwent motorized 0.8-1.3
micro-punch grafting from 2019 to June 2020.
Results: Thirty percent of the patients showed excellent
re-pigmentation ³75%. Forty percent of the patients showed
moderate re-pigmentation. Twenty percent of the cases showed
mild re-pigmentation and only 10% showed no improvement.
Conclusion: Micro-punch grafting is an effective way to
treat vitiligo; it is also considered a suitable option with
tolerable adverse events.

Keywords

Main Subjects

Aesthetics

References

1- Mulekar S.V.: Surgical Modalities in Management of
Vitiligo. Pigmentary Skin Disorders, 139-145, 2018.
2- Bae J.M., Lee J.H., Kwon H.S., Kim J. and Kim D.S.:
Motorized 0.8-mm micropunch grafting for refractory
vitiligo: A retrospective study of 230 cases. Journal of
the American Academy of Dermatology, 79 (4): 720-727,
2018.
3- Kovacs D., Bastonini E., Ottaviani M., Cota C., Migliano
E., Dell'Anna M.L. and Picardo M.: Vitiligo skin: Exploring
the dermal compartment. Journal of Investigative
Dermatology, 138 (2): 394-404, 2018.
4- Huggins R.H., Henderson M.D., Mulekar S.V., Ozog
D.M., Kerr H.A., Jabobsen G. and Hamzavi I.H.: Melanocyte-
keratinocyte transplantation procedure in the treatment
of vitiligo: The experience of an academic medical
center in the United States. Journal of the American
Academy of Dermatology, 66 (5): 785-793, 2012.
5- Herskovitz I., Hughes O.B., Macquhae F., Rakosi A. and
Kirsner R.: Epidermal skin grafting. International Wound
Journal, 13 (S3): 52-56, 2016.
6- Bae J.M., Lee J.H., Kwon H.S., Kim J. and Kim D.S.:
Motorized 0.8-mm micropunch grafting for refractory
vitiligo: A retrospective study of 230 cases. Journal of
the American Academy of Dermatology, 79 (4): 720-727,
2018.
7- Babu A., Thappa D.M. and Jaisankar T.J.: Punch grafting
versus suction blister epidermal grafting in the treatment
of stable lip vitiligo. Dermatologic Surgery, 34 (2): 166-
178, 2008.
8- Sachdev M. and Shankar D.K.: Pulsed erbium: YAG laserassisted
autologous epidermal punch grafting in vitiligo.
International Journal of Dermatology, 39 (11): 868-871,
2000.
9- Gupta S. and Kumar B.: Epidermal grafting in vitiligo:
influence of age, site of lesion, and type of disease on
outcome. Journal of the American Academy of Dermatology,
49 (1): 99-104, 2003.
10- Hardman M.J. and Ashcroft G.S.: Estrogen, not intrinsic
aging, is the major regulator of delayed human wound
healing in the elderly. Genome Biology, 9 (5): 1-17, 2008.
11- NATALE C.A., DUPERRET E.K., ZHANG J., SADEGHI
R., DAHAL A., O'BRIEN K.T. and RIDKY T.W.: Sex
steroids regulate skin pigmentation through nonclassical
membrane-bound receptors. Elife, 5: e15104, 2016.
12- Filippova O.V., Afonichev K.A., Krasnogorskiy I.N. and
Vashetko R.V.: Clinical and morphological characteristics
of the vascular bed of hypertrophic scar tissue in different
periods of its formation. Pediatric Traumatology, Orthopaedics
and Reconstructive Surgery, 5 (3): 25-35, 2017.
14 Vol. 46, No. 1 / Usefulness of Micro-Punch Skin Grafting for Treatment of Resistant Vitiligo
13- Lahiri K., Malakar S., Sarma N. and Banerjee U.: Repigmentation
of vitiligo with punch grafting and narrowband
UV-B (311nm) a prospective study. Int. J. Dermatol., 45:
649-55, 2006.
14- Falabella R.: Surgical treatment of vitiligo: Why, when
and how. Journal of the European Academy of Dermatology
and Venereology: JEADV, 17 (5): 518-520, 2003