Melanocyte Transplantation
Melanocyte transplantation is the latest and most advanced surgical method for the treatment of vitiligo.
Vitiligo is a skin condition which causes clearly defined milky-white patches to appear on the skin. These patches can occur on any part of the body.
Melanocytes are the skin cells which produce melanin. A complete absence of skin colour usually means the melanocytes have been destroyed. Thanks to an innovative treatment, it is now possible to take melanocytes from a healthy area of skin and transfer them in a suspension onto the damaged area of skin.
This process can be carried out in a clinic in one to three hour. It is important to note that this is not a melanocyte culturing process.
Leucoderma is another form of loss of skin colour. Sometimes it is the result of trauma such as scar dischromia.
Which patients are most suited to melanocyte
transplantation?
Patients who have had stable vitiligo patches for a
period of at least 6 months are good candidates to undergo melanocyte
transplantation.
Patients should fulfill the following criteria to be eligible for
surgery.
- Existing patches
should not have increased in size.
- No new patches
should have appeared on other areas.
- Any injury
should heal with normal skin color.
Response according to type of vitiligo:
- Segmental.
Best response and most suitable. Success rate 94%
- Focal
Very
good response and suitable. Success rate 80%
- Vulgaris
Responds well on lower extremity,
poor response on face. Success rate 75%
- Acral
Poor response in all areas. Success rate 20%
Success rate of
treatment is 94% ie 94% of treated patients develop pigmentation
over 65% to 100% of the treated area.
Recurrence of vitiligo after melanocyte transfer treatment:
- Segmental Almost no recurrence
- Focal
Minimal
chance of recurrence. It can develop in vulgaris type.
- Vulgaris Can recur.
- Acral
Very high rate of recurrence
What
size area can be treated?
In one operative session up to 100 cm2 of white patches can be
treated depending
upon the sites involved. If the affected area is larger, patient has
to undergo multiple
treatment sessions.
Is one operative session enough for complete recovery?
Sometimes a few white spots remain once the treated area has
repigmented. These need to be retreated by melanocyte
transplantation. Approximately 30% patients require repeat surgery
for complete recovery.
Most advanced method
This is the most advanced surgical method to treat stable Vitiligo.
Large areas can be treated. Repigmentation occurs in about 4 to 6
months and cosmetic results are superior to other surgical methods
such as skin grafting, punchgrafts. Difficult areas such as bony
surfaces, the areola, genitals and knuckles can be treated with
excellent results.
Complications and side effects
- Since no medicines
are used except post-operative antibiotics, there are no side
effects.
- There may be a
hypopigmented ring at the borders of treated and repigmented
patches in some patients. Usually this ring disappears
automatically or with application of local steroids, or by
repeat surgery.
- Bacterial
infection. All patients are administered oral antibiotics to
prevent chances of infection.
The operation step by step
- A careful medical history and examination is recorded.
- In a surgical
theatre, a thin shave biopsy is taken under local anaesthesia to
remove donor skin from the waist.
The biopsy is processed using an enzyme to separate all layers of
skin and to make a skin cell suspension. This suspension
contains melanocytes which produce the skin colour melanin. The
suspension is spread on recipient area.
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