Gupta Somesh, Kumar Bhushan
Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Am Acad Dermatol. 2003 Jul;49(1):99-104. doi: 10.1067/mjd.2003.415.
The success of suction blister epidermal grafting may be influenced by various factors, all of which have not been studied to date.
We sought to determine the influence of age of the patient, site of vitiligo patch, and type of disease on the outcome of the procedure in our patients and in the cumulative data derived from literature analysis.
This was a retrospective, uncontrolled case series and literature review of suction blister epidermal grafting in patients with stable and recalcitrant vitiligo. All published studies of suction blister epidermal grafting in vitiligo involving 10 or more patients were included in the literature analysis.
The procedure was performed in 143 patients. However, sufficient length (6 postoperative months) of follow-up was available in only 117 patients, and only these patients were included for analysis. Only limited information was available about various factors in the majority of published studies. The success rates for generalized and segmental/focal disease in this study were 53% (confidence interval [CI] 42-64) and 91% (CI 81-100), respectively (P <.001), and in the literature, 61% (CI 46-76) and 88% (CI 82-94), respectively (P <.01). The success rates in patients aged < 20 years and >or= 20 years in this study were 82% (CI 67-97) and 58% (CI 48-68), respectively (P <.05), and in the literature, 100% and 66% (CI 56-76), respectively (P <.05). There was no significant difference in the success rates achieved on different body sites in this study and in the screened literature. Among adverse reactions, hyperpigmentation in 32% (CI 24-40) and 17% (CI 14-20), infection in 6% (CI 2-10) and 0%, and contact dermatitis in 1% (CI 0-3) and 1% (CI 0-2) of patients were observed in this study and in the analyzed literature, respectively.
The results were significantly better in segmental/focal vitiligo than in the generalized type, and in individuals < 20 years of age. However, unlike in medical therapies, localization of the vitiligo patch did not influence the treatment outcome significantly.
负压吸疱表皮移植术的成功率可能受多种因素影响，而目前尚未对所有这些因素进行研究。
我们试图确定患者年龄、白癜风斑块部位及疾病类型对我们的患者该手术结局的影响，以及对文献分析得出的累积数据的影响。
这是一项对稳定型和顽固性白癜风患者进行负压吸疱表皮移植术的回顾性、非对照病例系列研究及文献综述。文献分析纳入了所有已发表的涉及10例或更多患者的白癜风负压吸疱表皮移植术研究。
143例患者接受了该手术。然而，只有117例患者有足够长（术后6个月）的随访时间，仅这些患者被纳入分析。大多数已发表研究中关于各种因素的信息有限。本研究中泛发型和节段型/局限性疾病的成功率分别为53%（置信区间[CI]42 - 64）和91%（CI 81 - 100）（P <.001），文献中的成功率分别为61%（CI 46 - 76）和88%（CI 82 - 94）（P <.01）。本研究中年龄<20岁和≥20岁患者的成功率分别为82%（CI 67 - 97）和58%（CI 48 - 68）（P <.05），文献中的成功率分别为100%和66%（CI 56 - 76）（P <.05）。本研究及筛选出的文献中，不同身体部位的成功率无显著差异。在不良反应方面，本研究和分析的文献中分别观察到32%（CI 24 - 40）和17%（CI 14 - 20）的患者出现色素沉着，6%（CI 2 - 10）和0%的患者出现感染，1%（CI 0 - 3）和1%（CI 0 - 2）的患者出现接触性皮炎。
节段型/局限性白癜风患者的结果明显优于泛发型患者，且年龄<20岁的个体结果更好。然而，与药物治疗不同，白癜风斑块的部位对治疗结局无显著影响。
