Erbium: YAG laser and cultured epidermis in the surgical therapy of stable vitiligo

Liliana Guerra, Grazia Primavera, Desanka Raskovic, Graziella Pellegrini, Osvaldo Golisano, Sergio Bondanza, Patrizia Paterna, Giulio Sonego, Tommaso Gobello, Francesco Atzori, Paolo Piazza, Antonio Luci, Michele De Luca

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Objective: To induce complete and reproducible repigmentation of large "stable" vitiligo lesions by means of autologous cultured epidermal grafts using a rapid, simple, and minimally invasive surgical procedure. Design: Achromic epidermis was removed by means of appropriately settled erbium:YAG laser, and autologous epidermal grafts were applied onto the recipient bed. Melanocyte content was evaluated by dopa reaction. The percentage of repigmentation was calculated using a semi-automatic image analysis system. Setting: A biosafety level 3-type cell culture facility, a surgical ambulatory department, and a dermatological department in a hospital. Patients: Twenty-one patients with different types of vitiligo were admitted to the study and treated with autologous cultured epidermal grafts. Inclusion criteria were failure of at least 2 standard medical approaches; no therapy for at least 12 months; no progression of old lesions or appearance of new lesions; no Koebner phenomenon within the past 18 months; and no autoimmune disorders. Results: The average percentage of repigmentation in 21 patients was 75.9% (1759.7 cm 2 repigmented/2315.8 cm2 transplanted). Three patients showed a reactivation of their vitiligo and did not show repigmentation. The remaining 18 patients, with 43 distinct lesions, showed an average percentage of repigmentation of 90% (1759.7 cm2 repigmented/1953.4 cm 2 transplanted). Conclusions: Under appropriate conditions, cultured epidermal grafts induce complete repigmentation of stable vitiligo lesions. Erbium:YAG laser surgery can supply a fast and precise tool for disepithelialization, hence allowing treatment of large vitiligo lesions during a single surgical operation.

Original languageEnglish
Pages (from-to)1303-1310
Number of pages8
JournalArchives of Dermatology
Issue number10
Publication statusPublished - Oct 2003

ASJC Scopus subject areas

  • Dermatology


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