Autologous Punch Grafting In Vitiligo : A Six Year Study (Preliminary Report)

Abstract

A6-year study (1989-1995) on autologous punch grafting was performed in 410 different sites of 184 resistant, stable and localized vitiligo patients and Calcutta Skin institute. Grafting was undertaken by skin biopsy punch and curved scissors keeping a distance of 1-2 cm between adjoining grafts, the donor site graft being 0.5 mm to1mm larger than the recipient one. 12 cases were halo nevus, the central mole of which was excised and subsequently grafted. The grafts were well accepted in 385 (93.9%) sites and rejected in 20 (4.9%) sites due to secondary infection and in 5 (1.2%) for poor care in immobilization by the patients. Spontaneous pigment- spread was seen in 77(18.8%) sites, predominantly on face, neck and upper trunk. Post-surgical psoralen with seen at all in 13 (3.2%) sites, mainly located on bony prominences (tibial surface and maleoli), fingers and feet. Perigraft hyper-pigmentation was seen in 29(7.1%)sites, especially on sun-exposed area. Excellent pigment-spread was seen in 8(66.7%) cases of halo nevus: 3 (25%) showed sinking pits and 1(8.3%) remnant of mole. Raised graft surface (cobble stoning) was not uniform in 36 (8.8%) sites. Keloidal growth at donor sites was seen in 12 (2.9%) cases. This simple, unique, economic, outdoor-based, effective and cosmetically acceptable procedure may be a positive answer to many refractory vitiligo patients.