Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA.
Creighton University School of Medicine, Omaha, NE, USA.
Int J Dermatol. 2018 Jul;57(7):770-775. doi: 10.1111/ijd.13895. Epub 2018 Jan 10.
Vitiligo is an acquired pigmentary skin of depigmentation occurring secondary to melanocyte destruction. Vitiligo and other leukodermas have a profound impact on quality of life. Current therapies include medical options, such as phototherapy, topical and systemic corticosteroids, topical calcineurin inhibitors, immunomodulators, and antioxidiants, and surgical options. Surgical options provide melanocytic cells to previously depigmented areas and use either tissue grafting or cellular grafting methods. Topical treatments are often insufficient, and many of the current surgical procedures have shown variable response rates. In this review, we discuss the process of the cellular grafting melanocyte-keratinocyte transplantation procedure (MKTP) and critically analyze its efficacy and safety in the treatment of vitiligo and other leukodermas. PubMed was searched for studies (2001-2017) describing the use of MKTP in patients with vitiligo or other leukodermas. Articles or trials discussing the use of MKTP for these patients were selected for in-depth review. Clinically relevant results regarding efficacy and safety of MKTP in vitiligo and leukoderma patients were analyzed. Numerous trials and case series/reports have demonstrated tolerability and efficacy of MKTP with repigmentation for patients with refractory, stable vitiligo. However, the response rates have been variable, likely influenced by vitiligo type and affected areas. Future research and clinical reporting will provide more insight on which phenotypes may benefit from MKTP.
白癜风是一种获得性色素脱失性皮肤病,继发于黑素细胞破坏。白癜风和其他色素减退症对生活质量有深远影响。目前的治疗方法包括医学选择,如光疗、局部和全身皮质类固醇、局部钙调神经磷酸酶抑制剂、免疫调节剂和抗氧化剂,以及手术选择。手术选择向以前色素脱失的区域提供黑素细胞,并使用组织移植或细胞移植方法。局部治疗往往不足,许多目前的手术程序显示出不同的反应率。在这篇综述中,我们讨论了细胞移植黑素细胞-角质形成细胞移植程序 (MKTP) 的过程,并批判性地分析了其在治疗白癜风和其他色素减退症中的疗效和安全性。我们在 PubMed 上搜索了描述 MKTP 在白癜风或其他色素减退症患者中使用的研究(2001-2017 年)。选择讨论了 MKTP 用于这些患者的文章或试验进行深入审查。分析了 MKTP 在白癜风和色素减退症患者中的疗效和安全性的临床相关结果。许多试验和病例系列/报告已经证明了 MKTP 对难治性、稳定型白癜风患者的耐受性和疗效,出现色素再生。然而,反应率各不相同,可能受白癜风类型和受累区域的影响。未来的研究和临床报告将提供更多关于哪些表型可能受益于 MKTP 的信息。