白癜风皮损稳定性对于进行外科干预是否比疾病稳定性更重要？一项多中心研究的结果

Is Lesional Stability in Vitiligo More Important Than Disease Stability for Performing Surgical Interventions? Results from a Multicentric Study.

作者信息

Majid Imran, Mysore Venkataram, Salim Thurakkal, Lahiri Koushik, Chatterji Manas, Khunger Niti, Talwar Suresh, Sachhidanand S, Barua Shyamanta

机构信息

CUTIS Institute of Dermatology, Srinagar, Kashmir, India.

Venkat Charmalaya Centre for Advanced Dermatology and Postgraduate Training, Bangalore, India.

出版信息

J Cutan Aesthet Surg. 2016 Jan-Mar;9(1):13-9. doi: 10.4103/0974-2077.178538.

DOI:10.4103/0974-2077.178538

PMID:27081244

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4812882/

Abstract

BACKGROUND

Ensuring stability of the disease process is essential for undertaking surgical intervention in vitiligo. However, there is no consensus regarding the minimum duration of stability or the relative importance of disease and lesional stability in selecting patients for vitiligo grafting.

AIM

This multicentric study aims to assess the relative importance of lesional and disease stability on selecting patients for vitiligo grafting.

MATERIALS AND METHODS

One hundred seventy patients were recruited into the study and divided into two groups: Group A with lesional stability of >1 year but overall disease stability of only 6-11 months and Group B with overall disease stability of >1 year. Patients underwent either tissue or cellular vitiligo grafting on the selected lesions and the repigmentation achieved was scored from 0 (no repigmentation) to 6 (100% repigmentation). Repigmentation achieved on different sites of the body was compared between the two groups. Adverse effects at both the donor and the recipient sites were also compared.

RESULTS

Of the 170 patients who were enrolled, 82 patients were placed in Group A and 88 patients in Group B. Average repigmentation achieved (on scale of 0 to 6) was 3.8 and 4.04 in Group A and Group B, respectively. In Group A, ≥90% repigmentation was achieved in 36.6% (30/82) patients, while 37.5% (33/88) achieved similar results in Group B. Additionally, 47.6% (39/82) and 53.4% (47/88) of cases achieved partial repigmentation in Group A and Group B, respectively. Perigraft halo was the commonest adverse effect observed in both groups. Statistical analysis revealed no significant differences between the two groups with respect to the repigmentation achieved or adverse effects observed. Repigmentation achieved was the best on the face and neck area, while acral areas responded the least.

CONCLUSIONS

Lesional stability seems to be as relevant as the overall disease stability in selecting patients for surgical intervention in vitiligo.

摘要

背景

确保疾病进程的稳定性对于白癜风的手术干预至关重要。然而，关于稳定性的最短持续时间或疾病与皮损稳定性在选择白癜风移植患者时的相对重要性，目前尚无共识。

目的

这项多中心研究旨在评估皮损稳定性和疾病稳定性在选择白癜风移植患者时的相对重要性。

材料与方法

170例患者被纳入研究并分为两组：A组皮损稳定性>1年，但整体疾病稳定性仅为6 - 11个月；B组整体疾病稳定性>1年。患者在选定的皮损上接受组织或细胞白癜风移植，将色素恢复情况从0（无色素恢复）至6（100%色素恢复）进行评分。比较两组患者身体不同部位的色素恢复情况。同时比较供体和受体部位的不良反应。

结果

在纳入的170例患者中，82例被分入A组，88例被分入B组。A组和B组的平均色素恢复情况（0至6分）分别为3.8和4.04。在A组中，36.6%（30/82）的患者色素恢复≥90%，而B组中37.5%（33/88）的患者达到了类似结果。此外，A组和B组分别有47.6%（39/82）和53.4%（47/88）的病例实现了部分色素恢复。移植周围晕是两组中最常见的不良反应。统计分析显示，两组在色素恢复情况或观察到的不良反应方面无显著差异。面部和颈部区域的色素恢复情况最佳，而肢端部位反应最差。