Clinical and treatment characteristics determining therapeutic outcome in patients undergoing autologous non-cultured outer root sheath hair follicle cell suspension for treatment of stable vitiligo

BackgroundAutologous non-cultured outer root sheath hair follicle cell suspension (NCORSHFS) is a recently described novel cellular graft technique for the treatment of stable vitiligo. There is lack of data about various factors determining the repigmentation rate in vitiligo patients undergoing this novel surgical therapy. ObjectiveTo study the clinical characteristics and treatment variables determining therapeutic outcome in patients of stable vitiligo undergoing NCORSHFS. MethodsNon-cultured outer root sheath hair follicle cell suspension was prepared from anagen hairs extracted from the occipital area. The number of melanocytes and hair follicle stem cells (HFSC) in the suspension was quantified by staining with anti-HMB45 and anti-CD200 antibody, respectively. In all patients, a 2mm punch skin biopsy was taken from one of the vitiligo patch to be treated prior to surgery for assessment of histomorphological features. Post surgery patients were followed up at regular intervals for 24weeks. ResultsThirty patients (21 females, 9 males) with a clinical diagnosis of stable vitiligo, with a total of 60 target lesions were included in this study. The mean age of the study population was 21.105.64years. The number of melanocytes (P=0.04) and HFSC (P=0.01) transplanted were significantly higher among patients achieving optimum repigmentation (>75% repigmentation). There was a strong correlation between repigmentation at 24week and number of melanocytes and HFSC transplanted. Number of HFSC transplanted and absence of dermal inflammation were significant predictors of achieving optimum repigmentation. ConclusionThe number of melanocytes and HFSC transplanted and absence of dermal inflammation were important determents of optimal repigmentation in patients undergoing NCORSHFS for treatment of stable vitiligo. Hence, refining the technique of NCORSHFS on the basis of these factors would help in achieving better surgical outcomes.