Follow-up study of vitiligo patients treated with autologous epidermal sheet transplants

Background: Autologous epidermal transplantation is available for the treatment of stable vitiligo. However, the results of this technique are affected by many factors. Objectives: It is important to investigate the long-term results and factors that might influence the outcome of the autologous epidermal grafting technique to form a basis for guidance for patients with vitiligo. Methods: We performed a follow-up study involving 173 patients (95 male, 78 female) with vitiligo vulgaris and 109 patients (59 male, 50 female) with segmental vitiligo who underwent autologous epidermal grafting. We investigated the long-term percentage of repigmentation and colour matching up to 13 years after treatment (mean 1.87 years). Results: The mean percentage of repigmentation in the total of 1938 sheets was 80.65%. In patients with vitiligo vulgaris, 110 (63.6%) showed excellent repigmentation, 18 (10.4%) showed good, 4 (5.8%) showed fair and 12 (20.2%) showed poor repigmentation. In patients with segmental vitiligo, 83 (76%) showed excellent repigmentation, 10 (9%) showed good, 4 (4%) showed fair and 12 (11%) showed poor repigmentation. In segmental vitiligo, the degree of repigmentation was significantly higher than that in vitiligo vulgaris lesions. Better outcomes were obtained in female patients and less than 20 years old patients, whereas results in male patients and more than 20 years old were inferior in both vitiligo vulgaris and segmental vitiligo patients. The face and neck had a higher completely matching ratio in the treated area with the surrounding skin compared to the non-exposed sites. However, the face and neck had a lower repigmentation in vitiligo vulgaris. There was a higher ratio of Koebner phenomenon on the donor site and new lesions on the other sites in 45 no repigmentation patients. Conclusions: Autologous epidermal transplantation achieves a high percentage of repigmentation which is affected by sex, age, types, position, duration and the stability time before transplantation in vitiligo patients. A more perfect colour matching was obtained in exposure sites. Disease activity after transplantation was very important for repigmentation or not.