Dr Sanjeev Mulekar - Specialist in Dermatology and the Treatment of Vitiligo

Non-Vitiligo Indications
There are several reasons, other than Vitiligo, why an individual may experience the loss of pigment. Some of these reasons are listed below and are eligible for treatment by Melanocyte Keratinocyte Transplantation (MKT).

Post-burn Leucoderma
A burn is a common accidental injury seen in medical practice. It results in scarring and fairly frequently, hypo or de-pigmentation. Normal pigmentation returns in many patients without any treatment, within about 6 months after complete healing. Some patients however, experience permanent hypo/depigmented patches similar to that of vitiligo. This is mainly due to mechanical destruction of melanocytes resulting in vitiligo like lesions. Hence it is called post burn-leucoderma.

Post-burn leucoderma can be successfully treated by surgical transplantation methods. Any kind of medical treatment including photo therapy is likely to be unsuccessful.

Piebaldism
This is a hereditary disorder characterized by milky white patches of variable size and shape. These patches are present since birth and remain unchanged throughout life and are located on the front portion of the body (ventral part of the body).

The cause of the disease is genetic and results in a complete absence of melanocytes in the affected areas. Other factors like autoimmunity and cytotoxicity are completely absent. This disease does not respond to any kind of medical therapy.

Transplantation of melanocytes almost always gives excellent outcomes with very good re-pigmentation. Any surgical method will produce good results. Non-cultured epidermal cell transplantation may be the best option to treat large patches of piebaldism.

Leucoderma caused by laser
Lasers have been increasingly used in dermatology to treat vascular disorders, hair removal, hyper pigmented disorders, tattoo removal etc. These treatments sometimes lead to white spots. Melanocyte Keratinocyte Transplantation (MKT) may be used to treat these white patches with good results.

Chemical Leucoderma (contact leucoderma)
Certain chemicals like quinon and hydroquinone cause pigment cell destruction leading to white spots. These chemicals are present in industry and cosmetics. Occasionally phenol or tricholracetic peeling may also lead to white patches. MKT can be considered to treat such lesions.

Halo Nevus
Halo nevus consists of a pigmented mole surrounded by sharply outlined area of depigmentation. Although it is often associated with vitiligo, in most cases it is a separate entity. Sometimes the central mole or the pigmented mole disappears spontaneously and the depigmeted area pigments spontaneously. These nevi have been successfully treated by transplantation methods when they become stable.

Nevus depigmentosus
This is a localized hypo pigmented non-progressive lesion, which remains unaltured throughout life. It appears at birth or within a few months after birth. The exact cause of nevus is not known. Any kind of medical treatment including photo therapy is not effective. Transplantation methods have been tried to treat this disease with variable results.

Discoid lupus erythematosus
This disease can lead to scarred and depigmented patches on the face and upper chest. Usually these lesions fail to respond to medical treatments. There are only 2 reports in the literature which show very good results with surgical treatment. However, more studies with long term follow up will be helpful to assess / prove the efficacy of surgical therapies.