“Vitiligo -is a persistent condition in which areas of skin lose their normal pigment and become very pale or pink. It can start at any age after birth. The extent of the condition is unpredictable, varying from single small patches to total loss of skin color. It needs long term treatment which includes both medical lines as well as a surgical line of management.”
Surgical treatment of Vitiligo is the final resort to regain the pigmentation in lesions failing to re-pigment despite various medical and light therapies. Multiple cellular and tissue graft techniques are used successfully to introduce melanocytes or their stem cells to vitiligo lesions devoid of them. Autologous melanocyte culture transfer is a time-consuming but quite simple surgical procedure in Vitiligo.
The basic steps involved in this procedure are as follows :
- First harvesting a graft, it may be skin or hairs.
- In the Trypsinisation of graft, the graft is placed in a trypsin solution and is kept in an incubator at 37-degree temperature. In this step, enzyme trypsin acts on the cellular level and helps in the separation of epidermis and dermis.
- Separation of melanocyte and making its pellet with the help of a centrifuge.
- Making suspension of these melanocytes in specialized medium (dmem).
- Recipient site preparation.
- Finally, implanting these cells over the recipient area and dressing.
The outcome of this procedure depends on many factors which may depend on patients and the technique used.
These are as follows :
- Duration of disease stability
- Type of vitiligo
- Extent of vitiligo
- Disease duration
- Site of lesion
- Donor tissue, type of tissue used
- Anatomical site
- Recipient site preparation
- Dressing wound care
MKTP is a safe technique with minimal complications. These include short-term complications in the form of infection or erythema and long-term complications, the most important of which are scars and color mismatch.