치료에 반응하지 않는 백반증의 흡입수포 표피 자가 이식술의 치료 효과 분석

Abstract

Background: There are many therapeutic methods for treating vitiligo including PUVA, narrow-band UVB, topical corticosteroids, tacrolimus, calcipotriol, intralesional injection of steroids or oral corticosteroids, but there is no reliable treatment. Autologous epidermal grafting has been used by several authors, and is reported to be a surgical method which has minimal adverse effect, little risk of scarring, and is easily performed in the clinic. Objective: The purpose of this study was to evaluate the effectiveness of autologous epidermal grafting in the treatment of vitiligo, and investigate both patient satisfaction, and any adverse effects. Methods: The evaluation was conducted using 44 patients (48 cases) with intractable vitiligo who had been treated by autologous epidermal grafting using suction blistered epidermis. We investigated both patient satisfaction, and any problems or adverse effects during the procedure. The efficacy was rated as excellent (repigmentation >75%), good (repigmentation 75-50%), fair (repigmentation 50-25%), or poor (repigmentation <25%). Efficacies according to clinical type, recipient sites, the preparation method for recipient sites, the disease duration at operation and the duration after operation were also investigated. Results: Excellent repigmentation was shown in 77.1% of the patients. The epidermal graft was more effective in treating segmental vitiligo, and when the disease duration was more than 36 months. Patient satisfaction was more than 75%. Conclusion: The autologous epidermal graft is an effective treatment modality. However, for more effective results and a high level of patient satisfaction we think doctors should only treat stable vitiligo. They should explain the operation procedure, side effects, and postoperative PUVA therapy in detail to the patient.