Agrawal K, Agrawal A
Department of Plastic Surgery, Jawaharlal Institute of Post-graduate Medical Education and Research, Pondicherry, India.
Dermatol Surg. 1995 Aug;21(8):711-5. doi: 10.1111/j.1524-4725.1995.tb00275.x.
Patients with vitiligo frequently have premature gray hair. Until recently the literature was silent about its management. While surgically treating vitiligo, we incidentally observed repigmentation of gray hair.
Based on our observations we undertook this study to see the effect of surgical treatment of vitiligo on repigmentation of leukotrichia, as well as to evaluate the percentage of repigmentation, if any, in the different hair-bearing areas, and the time taken for it.
A case series of eight patients with nine patches of localized, stable, and refractory vitiligo with leukotrichia of 3-12 years duration is presented. The patients were followed up for 2-6 years. One patient was lost from follow-up after 2 months. The vitiligo was treated by dermabrasion and thin split-thickness skin grafting under local anesthesia, as outpatients.
Repigmentation of the hair occurred in all the areas but it was seen earlier (3 months) and was more complete in the eyebrows (70-95%). In the scalp and the beard areas it started later (6-9 months) and was around 50-60% only. The degree of pigmentation increased until about 3 years after surgery. No complications in the form of graft loss or alopecia were observed.
Partial to near-total repigmentation of leukotrichia can be achieved surgically. Contrary to the present theory, we hypothesize that melanocytes also migrate from the repigmented epidermis to the hair follicle, resulting in repigmentation of the hair.
白癜风患者常伴有早生白发。直到最近，文献中仍未提及对其的治疗方法。在对白癜风进行手术治疗时，我们偶然观察到白发出现了色素再生。
基于我们的观察，开展本研究以观察白癜风手术治疗对白发色素再生的影响，评估不同毛发部位色素再生的百分比（如有）以及所需时间。
呈现了一个包含8例患者的病例系列，这些患者有9处局限性、稳定且难治的白癜风斑块，伴有3至12年病程的白发。对患者进行了2至6年的随访。1例患者在随访2个月后失访。白癜风采用局部麻醉下的磨皮术和薄断层皮片移植术作为门诊治疗。
所有部位的毛发均出现了色素再生，但在眉毛部位出现得更早（3个月）且更完全（70 - 95%）。在头皮和胡须部位则开始得较晚（6 - 9个月），仅约50 - 60%。色素沉着程度在手术后约3年一直增加。未观察到移植失败或脱发等并发症。
通过手术可实现白发部分至几乎完全的色素再生。与当前理论相反，我们推测黑素细胞也会从色素再生的表皮迁移至毛囊，从而导致毛发色素再生。
