BACKGROUND: Surgery is currently the most successful approach for difficult cases of vitiligo. The efficacy of epidermal surface removal (dermabrasion) is near 50%, and the efficacy of grafts is 70%. OBJECTIVE: To evaluate the efficacy and safety of a combined approach using dermabrasion and grafting for unresponsive vitiligo. PATIENTS AND METHODS: Eleven patients with stable vitiligo each underwent two different procedures on different body areas: transfer of melanocytes and epidermal cells obtained using the "sandpaper method" combined with dermabrasion of the receptor area or simple dermabrasion. Micropunch testing was used to evaluate the activity of vitiligo. Only patients without activity were treated. Subjects were followed for 3 months, and digital pictures were analyzed to estimate the percentage of repigmentation. RESULTS: Transfer delivered visible results in the first month, and dermabrasion showed results in the second month. The quality of pigmentation was superior with the transfer technique, especially in the short term, although at the end of treatment, both techniques showed similar results. CONCLUSIONS: Transfer of melanocytes and keratinocytes with the sandpaper method is feasible, safe, and effective as treatment for stable vitiligo, although simple dermabrasion is as effective in the long term.
BACKGROUND: Surgery is currently the most successful approach for difficult cases of vitiligo. The efficacy of epidermal surface removal (dermabrasion) is near 50%, and the efficacy of grafts is 70%. OBJECTIVE: To evaluate the efficacy and safety of a combined approach using dermabrasion and grafting for unresponsive vitiligo. PATIENTS AND METHODS: Eleven patients with stable vitiligo each underwent two different procedures on different body areas: transfer of melanocytes and epidermal cells obtained using the "sandpaper method" combined with dermabrasion of the receptor area or simple dermabrasion. Micropunch testing was used to evaluate the activity of vitiligo. Only patients without activity were treated. Subjects were followed for 3 months, and digital pictures were analyzed to estimate the percentage of repigmentation. RESULTS: Transfer delivered visible results in the first month, and dermabrasion showed results in the second month. The quality of pigmentation was superior with the transfer technique, especially in the short term, although at the end of treatment, both techniques showed similar results. CONCLUSIONS: Transfer of melanocytes and keratinocytes with the sandpaper method is feasible, safe, and effective as treatment for stable vitiligo, although simple dermabrasion is as effective in the long term.