“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 colour. It need long term treatment which includes both medical line as well as surgical line of management.”
Surgical treatment of vitiligo is the final resort to regain the pigmentation in lesions failing to repigment despite various medical and light therapies. Multiple cellular and tissue graft techniques are used successfully to introduce elanocytes and/or their stem cells to vitiligo lesions devoid of them. Autologous melanocyte culture transfer is time consuming but quite simple surgical procedure in vitiligo.
Basic steps involved in this procedure are as follows :
- First harvesting a graft it may be skin or hairs
- Trypsinisation of graft in which graft is placed in trypsin solution and this solution is kept in incubator at 37 degree temperature. In this step enzyme trypsin acts on cellular level and helps in separation of epidermis and dermis.
- Separation of melanocyte and making its pellet with the help of centrifuge.
- Making suspension of these melanocytes in specialised medium (dmem).
- Recipient site preparation.
- Finally implanting these cells over recipient area and dressing.
Outcome of this procedure depends on many factors which may depend on patients and 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.