Czajkowski Rafal, Placek Waldemar, Drewa Tomasz, Kowaliszyn Bogna, Sir Jan, Weiss Wioletta
Department of Dermatology and Department of Tissue Engineering, Nicolaus Copernicus University, Ludwik Rydygier Medical College, Bydgoszcz, Poland.
Dermatol Surg. 2007 Sep;33(9):1027-36; discussion 1035-6. doi: 10.1111/j.1524-4725.2007.33216.x.
Surgical treatment of vitiligo is indicated when lesions are localized in poorly responding areas.
The objectives were: (1) to establish the melanocyte culture obtained from the epidermis of vitiligo patients for future treatment; (2) to estimate the influence of selected factors on the formation of suction blisters and the results of culture; and (3) to compare the results of treatment of vitiliginous macules localized in the dorsum of the hands and lower limbs by transplantation of cultured autologous melanocytes plus psoralen and ultraviolet A (PUVA) therapy (CMP), suction blister transplantation plus PUVA therapy (SBP), cryotherapy plus PUVA-therapy (CP), and only PUVA therapy (OP).
Forty patients were qualified for the study. The roofs of the suction blisters were used as a melanocyte source for culture establishment or were directly transplanted.
The CMP procedure was successfully performed on only 10 of 20 patients because of the difficulties in cell culture establishment. The SBP method was carried out on all 20 patients. A total lack of effectiveness was found in CP and OP methods.
The effectiveness of culture depends on time of suction blister forming, phototype, and previous PUVA therapy. This study demonstrated the advantage of the SBP over the CMP method.
当白癜风皮损局限于反应欠佳的部位时,可考虑手术治疗。
目的如下:(1)建立从白癜风患者表皮获取的黑素细胞培养体系以备后续治疗使用;(2)评估选定因素对水疱形成及培养结果的影响;(3)比较采用培养的自体黑素细胞联合补骨脂素及紫外线A(PUVA)疗法(CMP)、水疱移植联合PUVA疗法(SBP)、冷冻疗法联合PUVA疗法(CP)以及单纯PUVA疗法(OP)对手背和下肢白癜风斑的治疗效果。
40例患者符合研究条件。水疱顶部用作建立培养体系的黑素细胞来源或直接进行移植。
由于细胞培养建立困难,CMP手术仅在20例患者中的10例成功实施。SBP方法在所有20例患者中均得以开展。CP和OP方法均未显示出任何疗效。
培养效果取决于水疱形成时间、光类型及既往PUVA治疗情况。本研究证实了SBP方法相对于CMP方法的优势。