Surgical interventions for vitiligo: an evidence-based review.

BACKGROUND

Vitiligo is a disfiguring disease, characterized frequently by the presence of de-pigmented macules and/or patches. Traditional therapies are essentially medical and are most preferred by dermatologists. Surgical therapies, however, are amongst the most effective interventions for vitiligo but are limited by their invasive nature, as well as the training and expertise needed to perform specific procedures.

OBJECTIVES

To assess the evidence for the effectiveness, safety and applicability of the various surgical methods in the treatment of vitiligo.

METHODS

For this systematic review of vitiligo surgical therapies, our searches included: PubMed, MEDLINE and Cochrane databases.

RESULTS

We reviewed research studies reporting on split thickness skin grafts (STSG), punch/mini-graft, blister roof grafting, cultured and non-cultured cellular transplantation (MKTP). While all methods vary in their repigmentation outcomes, STSG is found to have the highest repigmentation success rate. Overall, post-operative complications included milia, scarring, cobblestone appearance or hyperpigmentation of treated areas.

CONCLUSION

This review highlights the need for more randomized controlled trials in this field, underpinned by a more standardized objective approach to the assessment of repigmentation following surgical interventions.