Abstract:

Objective To evaluate the long-term outcome of autologous epidermal grafting in vitiligo and its correlated factors. Methods A 1-5 year follow-up of 310 patients with vitiligo, who had been treated by autologous epidermal grafting, was carried out by questionnaires, phone interview, and clinical revisit. The relevance was estimated between the efficacy of the treatment and several factors, including the time length from the grafting to the follow up, patients′ age and gender, location of lesions treated, Koebner phenomenon on the donor sites, and the combination therapy with narrow band-ultraviolet B （NB-UVB）. Results Of the 310 patients, 161 were males and 149 females with an average age of 26.69 ± 11.76 years; 98 had localized vitiligo, 123 segmental vitiligo, 62 scattered vitiligo, 27 generalized vitiligo. Totally, 24 recipient areas with 1266 sheets were evaluated. Among these sheets, 815 （64.38%） achieved complete repigmentation, 167 obvious repigmentation, 117 some repigmentation, 167 no repigmentation, with a curative rate of 64.38% and total effective rate of 86.81%. Hyperpigmentation occurred in the recipient area of 76 （24.52%） patients, and donor area of 34 patients （10.97%）, and hypopigmentation developed in the recipient area of 66 patients （21.29%）. Relapse developed in the recipient areas of 30 patients, and new lesions in 12 patients （3.871%）. Koebner phenomenon was noticed in the donor sites of 25 （8.064%） patients. The efficacy of autologous epidermal grafting was stable within two years after the therapy, but reduced with the time. Increased efficacy was observed in those sites with little mobililty and large fixity. For example, the best efficacy was observed in the legs and arms, followed by feet and hands, chest and back, face and neck, finally by waist and abdomen （P < 0.01）. NB-UVB exposure could improve the repigmentation. Koebner phenomenon in donor sites was associated with a reduced efficacy of epidermal grafting （P < 0.05）. Gender and age seemed unrelated to the efficacy. Conclusions Autologous epidermal grafting has a good long-term efficacy for the treatment of vitiligo, and transplanted location may be the most important factor affecting the efficacy.

Key words: Vitiligo;epidermal graft;autologous