Verma Manjulata, Saini Shivani, Rao Pankaj, Chouhan Chandraprakash, Kachhawa Dilip
Department of Dermatology, Venereology & Leprosy, Dr. SN Medical College, Jodhpur, Rajasthan, India.
J Cutan Aesthet Surg. 2022 Jan-Mar;15(1):33-39. doi: 10.4103/JCAS.JCAS_205_20.
Surgical treatment of vitiligo is reserved for stable recalcitrant vitiligo patches. Split-thickness skin grafting (STSG) is an important established modality for the surgical treatment of vitiligo, whereas autologous, non-cultured, non-trypsinized epidermal cell transplant, also known as Jodhpur technique (JT), is an unconventional innovative surgical modality for the treatment of stable vitiligo.
To compare the two techniques, JT and STSG, with regards to the extent and pattern of repigmentation achieved, color matching of the repigmented area, patient satisfaction (Dermatology Life Quality Index [DLQI] questionnaire and patient global assessment), and adverse events (if any) in patients with stable vitiligo.
It was a randomized comparative study. We randomized 32 patients with 180 stable vitiligo lesions into two groups. Patients in group 1 were treated with JT, and those in group 2 with STSG. They were subjectively evaluated 20 weeks post-surgery for the extent of repigmentation, color match, change in DLQI score, and patient satisfaction. The categorical data were presented as number (percent) and were compared among groups using Chi-square test. Mean and standard deviation were calculated for demographic data, and they were also compared by using student t-test. Probability value < 0.001 was considered statistically significant.
The extent of repigmentation was excellent (90%-100% repigmentation) in 72.5% of lesions in the JT group and in 40% of lesions in the STSG group ( < 0.001). Seventy-five percent repigmentation (good repigmentation) was observed in 95% of lesions in the JT group and in 83.75% of lesions in the STSG group ( = 0.040). There was a highly significant decline in DLQI score. Post-procedure DLQI (0.79 ± 1.13) and pre-procedure DLQI (15.39 ± 4.76) in the JT group were compared with post-procedure DLQI (3.85 ± 2.89) and pre-procedure DLQI (16.19 ± 4.56) in the STSG group. The mean decline among groups differed significantly ( < 0.001). Adverse events were significantly higher in the STSG group at the recipient site.
JT is found to be significantly better than STSG with regard to the degree of repigmentation.
白癜风的手术治疗适用于稳定的顽固性白斑。分层皮片移植（STSG）是白癜风手术治疗的一种重要的既定方式，而自体非培养、非胰蛋白酶消化的表皮细胞移植，也称为焦特布尔技术（JT），是治疗稳定型白癜风的一种非常规创新手术方式。
比较JT和STSG这两种技术在稳定型白癜风患者中色素沉着的程度和模式、色素沉着区域的颜色匹配、患者满意度（皮肤病生活质量指数[DLQI]问卷和患者整体评估）以及不良事件（如有）。
这是一项随机对照研究。我们将32例患有180处稳定型白癜风皮损的患者随机分为两组。第1组患者接受JT治疗，第2组患者接受STSG治疗。术后20周对他们进行主观评估，以评估色素沉着程度、颜色匹配、DLQI评分变化和患者满意度。分类数据以数字（百分比）表示，并使用卡方检验在组间进行比较。计算人口统计学数据的均值和标准差，并使用学生t检验进行比较。概率值<0.001被认为具有统计学意义。
JT组72.5%的皮损色素沉着程度极佳（色素沉着90%-100%），STSG组为40%的皮损（<0.001）。JT组95% 的皮损色素沉着达75%（色素沉着良好），STSG组为83.75%的皮损（=0.040）。DLQI评分有极显著下降。将JT组术后DLQI（0.79±1.13）和术前DLQI（15.39±4.76）与STSG组术后DLQI（3.85±2.89）和术前DLQI（16.19±4.56）进行比较。两组间的平均下降差异显著（<0.001）。STSG组受区的不良事件明显更多。
在色素沉着程度方面，发现JT明显优于STSG。
