Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
Br J Dermatol. 2010 Dec;163(6):1186-93. doi: 10.1111/j.1365-2133.2010.10014.x.
Several surgical techniques are available for the treatment of stable leucoderma. The use of noncultured epidermal cellular grafting was introduced in 1992. Data on long-term follow-up regarding stability of the repigmented area, time to achieve the final repigmentation, colour matching, reaction to sun exposure and patient satisfaction with treatment have been reported only a few times previously.
To evaluate the long-term results of the noncultured epidermal cellular grafting technique in patients with different types of leucoderma, including segmental vitiligo (n = 33), generalized vitiligo (n = 33), mixed vitiligo (n = 6), halo naevi (n = 11), piebaldism (n = 3) and naevus depigmentosus (n = 1).
Patients were evaluated by examination and questionnaire in a retrospective setting after transplantation by autologous noncultured cellular grafting. Percentage of repigmentation was evaluated in 82 patients using a digital imaging analysis system (mean follow-up 15 months). Long-term results were evaluated by 54 patients using a questionnaire up to 7·7 years after treatment (mean 4 years).
More than 75% repigmentation was achieved in 71% of patients. Best results were obtained in segmental vitiligo, halo naevi and piebaldism, whereas results in generalized or mixed vitiligo were inferior. According to the patients, final repigmentation was achieved after a mean of 10 months post-treatment. In 80% some colour mismatch (hyperpigmentation and hypopigmentation) was reported between the treated area and the surrounding skin, although this was not disturbing for the majority. This colour mismatch was reported significantly less after sun exposure (P = 0·012). During follow-up 7% of patients, all with generalized vitiligo, observed some loss of the achieved repigmentation.
Autologous epidermal cellular grafting achieved a high percentage of repigmentation, which was maintained during follow-up in the majority of patients. Although it improved quality of life, a perfect colour match was seldom obtained.
有几种手术技术可用于治疗稳定型白癜风。非培养表皮细胞移植技术于 1992 年引入。以前仅报道过几次关于复色区域稳定性、达到最终复色的时间、颜色匹配、对阳光暴露的反应和患者对治疗的满意度的长期随访数据。
评估非培养表皮细胞移植技术在不同类型白癜风患者中的长期疗效，包括节段性白癜风（n=33）、泛发性白癜风（n=33）、混合性白癜风（n=6）、晕痣（n=11）、斑驳病（n=3）和脱色素痣（n=1）。
在移植后通过自体非培养细胞移植，以回顾性方式对患者进行检查和问卷调查。使用数字成像分析系统评估 82 例患者的复色率（平均随访 15 个月）。54 例患者在治疗后长达 7.7 年（平均 4 年）时使用问卷进行了长期疗效评估。
71%的患者复色率超过 75%。节段性白癜风、晕痣和斑驳病的疗效最好，而泛发性或混合性白癜风的疗效较差。根据患者的报告，治疗后平均 10 个月达到最终复色。80%的患者报告称，治疗区域与周围皮肤之间存在一定程度的颜色不匹配（色素沉着过度和色素减退），但多数患者认为这并不令人困扰。经阳光照射后，这种颜色不匹配的报告明显减少（P=0.012）。在随访期间，7%的患者（均患有泛发性白癜风）观察到已获得的复色有一定程度的丧失。
自体表皮细胞移植可获得较高的复色率，且在大多数患者中随访期间复色得以维持。尽管它提高了生活质量，但很少能获得完全一致的颜色匹配。
