Melanocyte Transplantation Restores Original Skin Color In Vitiligo Patients

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Highlights:

• Vitiligo is a skin disease characterized by depigmentation (loss of color) of the skin.
• There is no known cure for the disease but can be treated via medications, skin grafts, and surgery.
• MKTP surgery uses patients own skin cells and offers a long-term benefit of restoring skin color in depigmented areas.

Vitiligo develops when the cells in our body responsible for producing pigment, also called melanocytes are killed by the body's immune system. This results in depigmentation or white lesions or blotches in affected areas. While there are multiple treatment options for vitiligo and other types of leukodermas, MKTP offers long-term benefits of re-pigmentation. Non-cultured Melanocyte-Keratinocyte Transplantation Procedure (MKTP) is the latest modification to surgical management to vitiligo and other leukodermas. A team at Henry Ford Hospitals conducted a retrospective study to determine the long-term re-pigmentation results in patients who have undergone MKTP between 2009 and 2014. The study is published in the Journal of the American Academy of Dermatology.

What is Vitiligo?

Leukoderma is defined as white patches on the skin and Vitiligo is a specific kind of leukoderma. However the two words are used interchangeably. Melanin is a pigment that gives human skin, eyes and hair their color. Melanin producing cells are called melanocytes. Vitiligo is a condition when these melanocytes die or do not function. This results in white depigmented patches on the skin. These patches are more visible on people with darker skin tone. They may appear anywhere on the body from skin, hair, lips to genitals. They may be acquired at any age but usually appear before 20 years of age. Vitiligo is non contagious (does not spread) and is treatable.

‘MKTP offers long time benefits of skin re-pigmentation in vitiligo-affected individuals.’

Signs of Vitiligo:

• Patchy loss of skin color
• Premature whitening /graying of hair on scalp, eyelashes, eyebrows or beard
• Loss of color in the tissues that line the inside of the mouth and nose
• Loss of or change in color of the inner layer of the eyeball

Vitiligo is of two types:

• Segmental: appears on one segment, or part, of the body like the face or arm.
• Nonsegmental: the most common type and appears on both sides of the body such as the hands and knees.

Melanocyte-Keratinocyte Transplantation Procedure (MKTP):

MKTP is the latest modification to surgical treatment procedure for vitiligo and other leukodermas. In this procedure the patient's own skin cells are taken from a pigmented area of the body (usually the upper thigh) and transplanted onto the affected white spot region after superficially removing the upper layer of the skin. It may be performed in 1 to 3 hours as a day care procedure. MKTP provides significant re-pigmentation by 6 months post surgery. Moreover, the difficult to treat areas like bony surface, areola, genitals and knuckles can also be treated with excellent results. However not everyone affected with vitiligo are recommended for the surgery. The inclusion criteria is as follows:

• Stable vitiligo: no history of enlarging or new lesions for at least 6 months.
• Segmental vitiligo
• Nonsegmental vitiligo without fingertip involvement
• Physical leukoderma caused due to mechanical, chemical or thermal causes.
• Piebaldism: Skin depigmentation from birth (genetic)
• Halo nevi: mole with a white patch around it

Long-term benefits of MKTP:

The study analyzed re-pigmentation results in 63 vitiligo patients who underwent MKTP between January 2009 and April 2014. All patients for whom clinical information was available for at least 12 months after the procedure were included in the study.

71% re-pigmentation was maintained in 45 segmental vitiligo lesions 5 years post MKTP

64% re-pigmentation was maintained in 90 non-segmental vitiligo lesions 5 years post MKTP

The study also indicates that skin type, age and location of the vitiligo had no significant effect on the outcome of the re-pigmentation. While it was previously known that significant re-pigmentation is achieved by 6 months post MKTP, this study concludes that MKTP can also maintain that re-pigmentation for at least 72 months.

However, it is important to note that treatment for vitiligo may restore color to the affected skin, but it does not prevent continued loss of skin color or a recurrence and is not a permanent cure to the disease.

References:

1. Overview - Vitiligo - (http://www.mayoclinic.org/diseases-conditions/vitiligo/home/ovc-20319041)
2. Michelle Rodrigues, Khaled Ezzedine, Iltefat Hamzavi, Amit G. Pandya, John E. Harris. New discoveries in the pathogenesis and classification of vitiligo. Journal of the American Academy of Dermatology, 2017; 77 (1): 1 DOI: 10.1016/j.jaad.2016.10.048
3. Narumol S, Griffith J, Huggins R, henderson M, Kerr H, Jacobsen G, Mulekar S, Lim H & Hamzavi I. Long-term follow-up of patients undergoing autologous noncultured melanocyte-keratinocyte transplantation for vitiligo and other leukodermas. Journal of American Academy of dermatology.(2017)

Source: Medindia

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