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March 2001

VitiligoThe Evolution of Cultured Epidermal Autografts and Other Surgical Treatment Modalities

Arch Dermatol. 2001;137(3):348-349. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-137-3-ded00004

VITILIGO, an acquired presumptively immunologic disorder of epidermal pigmentation, is manifested as sharply demarcated white macules. Epidermal melanocytes are absent or greatly diminished in involved areas, and all treatment modalities attempt to regenerate the epidermal melanocyte population. Topical class I glucocorticoid applications and systemic or topical use of psoralen–UV-A currently are the dominant forms of therapy,1 but are unsatisfactory for many patients. Lack of reliably effective medical therapies has led to the development of surgical treatment options (reviewed in references 2-424): epidermal grafting and "minigrafting," techniques that do not require cell expansion, and transplantation of autologous cultured melanocytes or keratinocyte/melanocyte cocultures in which the number of patient melanocytes in a biopsy specimen of normal skin is increased severalfold in the laboratory before the cells are transplanted to a depigmented area.

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