Guerra L, Primavera G, Raskovic D, Pellegrini G, Golisano O, Bondanza S, Kuhn S, Piazza P, Luci A, Atzori F, De Luca M
Laboratory of Tissue Engineering, Istituto Dermopatico dell'Immacolata, Rome, Italy.
Br J Dermatol. 2004 Apr;150(4):715-21. doi: 10.1111/j.0007-0963.2004.05500.x.
Several surgical techniques have been proposed for the treatment of piebaldism. These procedures, however, are poorly suited for the treatment of large leucodermal lesions, can cause scars and require multiple donor sites. Recently, it has been reported that autologous cultured epidermis induces scarless repigmentation of large vitiligo lesions, using a single small donor site.
To induce permanent repigmentation of large achromic lesions in patients suffering from piebaldism by means of autologous cultured epidermal grafts using a rapid, simple and non-invasive surgical procedure.
Six patients with piebaldism were enrolled in this study. Achromic epidermis was removed by means of appropriately set erbium:YAG laser and autologous cultured epidermal grafts were applied on to the recipient bed. Melanocyte content was evaluated by 3,4-dihydroxyphenylalanine reaction. The percentage of repigmentation was calculated using a semiautomatic image analysis system.
Autologous cultured epidermis, bearing a controlled number of melanocytes, induced repigmentation of all piebald lesions. The mean percentage repigmentation was 95.45% (2791.5 cm2 repigmented/2924.2 cm2 transplanted).
Autologous cultured epidermal grafts induce permanent and complete repigmentation of piebald lesions, in the absence of scars. Erbium:YAG laser surgery is a rapid and precise tool for disepithelialization, hence allowing treatment of large piebald lesions during a single surgical operation.
已经提出了几种用于治疗斑驳病的外科技术。然而，这些手术方法不太适合治疗大面积的白色皮肤病变，可能会导致疤痕形成，并且需要多个供区。最近，有报道称自体培养表皮可利用单个小供区诱导大面积白癜风病变无瘢痕性色素再生。
通过使用快速、简单且无创的外科手术方法进行自体培养表皮移植，诱导斑驳病患者大面积无色素病变实现永久性色素再生。
本研究纳入了6例斑驳病患者。使用适当设置的铒：钇铝石榴石激光去除无色素表皮，并将自体培养表皮移植到受区创面。通过3,4-二羟基苯丙氨酸反应评估黑素细胞含量。使用半自动图像分析系统计算色素再生的百分比。
带有可控数量黑素细胞的自体培养表皮诱导了所有斑驳病变的色素再生。色素再生的平均百分比为95.45%（色素再生面积2791.5平方厘米/移植面积2924.2平方厘米）。
自体培养表皮移植可在无瘢痕的情况下诱导斑驳病变实现永久性和完全性色素再生。铒：钇铝石榴石激光手术是一种快速且精确的去上皮工具，因此能够在单次手术中治疗大面积的斑驳病变。
