Heal House Vitiligo Research 16 · Original Article
Can widespread refractory vitiligo be grafted over a large area at once?
Non-cultured Epidermal Cell Suspension Transplantation Using Suction Blisters to Treat Refractory Vitiligo: A Retrospective Study of 20 Cases
Last reviewed
In short
With non-cultured epidermal cell suspension, which transfers epidermal cells from a small blister skin to a large vitiligo area, over 75% repigmentation was achieved in 85% of 20 cases.
For vitiligo that does not improve with phototherapy, surgery to transplant normal skin is an alternative. However, the long-used suction blister graft required transferring normal skin and white patches in a 1:1 ratio. Therefore, when lesions were large, there was a limitation of insufficient normal skin to harvest. We wondered whether non-cultured epidermal cell suspension, which spreads cells obtained from a small donor site multiple times, could overcome this barrier. So we collected the 20 cases performed so far and carefully reviewed them.
Q1 What were the results?
Among the 20 treated cases, 85% (17 cases) achieved 75% or more repigmentation of the grafted area. There were 17 patients, with a median age of 25 years. Cells obtained from a small blister 20 mm in diameter were spread onto the white patches at a 1:5 ratio. This means that a small piece of normal skin covered a lesion five times its area. The ability to use this method even for widespread vitiligo is its greatest strength.
Results of 20 cases of non-cultured epidermal cell suspension
| Item | Content |
|---|---|
| Target | Refractory vitiligo 20 cases · 17 patients (median age 25 years) |
| Donor-to-recipient ratio | 1 : 5 (small skin covers a large area) |
| Treatment success (≥75% repigmentation) | 85% (17/20) |
| Side effects | Hyperpigmentation 20% · Graft site infection 5% |
Q2 Were there any side effects or risks?
There were no serious problems, and all cases were tolerable. In some cases, the treated area became darker than the surrounding skin (20%), and there were mild infections (5%). All were well managed. Darkening of the skin usually becomes more natural over time. Infections are not a major issue if addressed early. Considering the advantage of being able to treat large lesions at once, we judged this to be an acceptable level of risk.
Closing remarks
This study confirmed that non-cultured epidermal cell suspension transplantation is a procedure we can confidently recommend for widespread refractory vitiligo. Because a small piece of skin can cover a large area, it opens a path for those who hesitated due to insufficient normal skin to harvest. I summarized our experience with the hope that this method becomes more widely used in Korea.
