Treatment of "stable" vitiligo by timedsurgery and transplantation of cultured epidermal autografts
Treatment of "stable" vitiligo by timedsurgery and transplantation of cultured epidermal autografts
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DOI：
10.1001/archderm.136.11.1380
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发表时间：
2000-11-01
影响因子：
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通讯作者：
Pellegrini, G
中科院分区：
文献类型：
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作者：
Guerra, L;Capurro, S;Pellegrini, G
目的：为了优化黑素细胞/角质形成细胞共培养和评估的有效性，自体培养的表皮移植物在手术治疗稳定的白癜风。设计：优化后的黑素细胞/角质形成细胞文化，无色病变disepithelialized通过程序化diathermosurgery（Timedsurgery）和覆盖自体表皮移植物制备的二次培养;黑素细胞含量进行了评价多巴反应。再色素沉着的百分比计算使用半自动图像分析system.Setting：生物安全3级细胞培养设施和皮肤科在医院：患者：32例患者携带不同类型的白癜风入院的研究和治疗自体培养的表皮移植。入选标准为（1）至少2项标准医疗失败。方法;（2）至少12个月未治疗;（3）在过去18个月内无旧病灶进展、无新病灶出现、无Koebner现象;（4）无自身免疫性疾病。随访12 ~ 36个月后，平均色素恢复率为77%。与白癜风的类型无关，四肢和周围部位的平均色素沉着率分别为8%（31.8 cm（2）色素沉着/420.5 cm（2）移植）和35%（17.6 cm（2）色素沉着/50.0 cm（2）移植）。所有其他身体部位的色素沉着恢复率为88%至96%（4329.7 cm（2）色素沉着恢复/4675.2 cm（2）移植）。颜色匹配是好的，疤痕形成是没有observed.Conclusion：培养表皮移植可以被认为是一个真实的治疗手术的选择“稳定”，但不是唇尖白癜风。
Objective: To optimize melanocyte/keratinocyte cocultivation and to evaluate the effectiveness of autologous cultured epidermal grafts in the surgical treatment of stable vitiligo.Design: After optimization of melanocyte/keratinocyce cultures, achromic lesions were disepithelialized by means of programmed diathermosurgery (Timedsurgery) and covered with autologous epidermal grafts prepared from secondary cultures; Melanocyte content was evaluated by dopa reaction. The percentage of repigmentation was calculated using a semiautomatic image analysis system.Setting: A biosafety level 3 cell culture facility and a dermatological department in a hospital:Patients: Thirty-two patients carrying different types of vitiligo were admitted to the study and treated with autologous cultured epidermal grafts. Inclusion criteria were (1) failure of at least 2 standard medical. approaches; (2) no therapy for at least 12 months; (3) absence of progression of old lesions, absence of appearance of new lesions, and absence of Koebner phenomenon within the past 18 months; and (4) absence of autoimmune disorders.Results: One hundred five achromic lesions (a total of 6078.2 cm(2)) were treated. The average percentage of repigmentation, evaluated after 12 to 36 months of:follow-up, was 77%. Independent of the type of vitiligo, average percentages of repigmentation of extremities and periorificial sites were 8% (31.8 cm(2) repigmented/420.5 cm(2) transplanted) and 35% (17.6 cm(2) repigmented/50.0 cm(2) transplanted), respectively. Percentages of repigmentation of all other body sites ranged from 88% to 96% C4329.7 cm(2) repigmented/4675.2 cm(2) transplanted). Color matching was good, and scar formation was not observed.Conclusion: Cultured epidermal grafts can be considered a real therapeutic surgical alternative for "stable" but not lip-tip vitiligo.