The Study On The Effectiveness Of Blister Grafting And New Pigmentation Spots And Recell Technology In The Treatment Of Patients With Stable Vitiligo

BackgroundVitiligo is a depigmented disease of unknown cause,with an incidence of up to 0.5-2%[1],so it has become a common disease.Although it is not difficult to diagnose,it has become a difficult disease in treatment.Depigmentation at multiple sites severely affects the appearance.Although it is not life-threatening,it has a huge psychological impact on patients.A large number of patients have huge mental disorders,so they have urgent need for treatment[2].At present,vitiligo is firstly considered to be treated by the systemic and local drug treatment and phototherapy of internal medicine and dermatology,to improve the systemic immune state and the microenvironment of local lesions so that it can bring about repigmentation,stabilize the symptoms of vitiligo patients,and prevent the number of depigmented sites from increasing and the area from expanding.Nevertheless,more than 80%of the patients still cannot achieve satisfactory repigmentation results,and need to undergo the second stage of surgical intervention for repigmentation treatment.Traditional surgical therapies include split-thickness skin grafting,suction blister epidermal grafting(blister grafting),etc.These methods are simple,effective,and widely used,but they also have some shortcomings such as low efficiency and uneven repigmentation,which are difficult to promote[3].Autologous non-cultured epidermal cell suspension transplantation,also known as ReCell technology,uses trypsin to dissociate the epidermis into the cell suspension containing keratinocytes,melanocytes and other cellular components and transplants it to the vitiligo area for melanin regeneration,which can effectively treat stable vitiligo[4].However,not all cell transplantation has achieved excellent results in the early stage.Therefore,in order to improve the efficacy of autologous non-cultured epidermal cell suspension transplantation,ReCell technology,in the treatment of patients with stable vitiligo,appropriate preoperative evaluation methods are required to screen stable vitiligo patients who are suitable for the surgery.ObjectiveTo investigate the efficacy of blister grafting and new pigmentation spots in the ReCell(?)therapy of stable vitiligo patients.MethodsThis article retrospectively analyzed the medical records of stable vitiligo patients treated with surgery from October 2015 to August 2019.49 patients had undergone dermabrasion and autologous non-cultured epidermal cell suspension transplantation,of which 36 patients successfully underwent suction blister epidermal grafting(blister grafting is effective),while the remaining 13 patients did not undergo blister grafting test.And 152 patients with stable vitiligo after medical treatment were treated with dermabrasion and autologous non-cultured epidermal cell suspension transplantation.They were also divided into two groups:80 patients in the first group had new pigmentation spots after the previous treatment,while 72 patients in the second group did not.Three and six months after surgery,the repigmentation results of each patient were evaluated.ResultsThe degree of repigmentation was divided into excellent(?76%),good(50%-75%),fair(26%-49%)or poor(?50%)according to the proportion of pigment regeneration area and the original lesion area before treatment.In the blister grafting group,repigmentation at 6 months postoperative was excellent in 50.0%versus 15.4%,good in 36.1%versus 23.1%,fair in 13.9%versus 30.8%,and poor in 0%versus 30.8%respectively.While in the new repigmentation spot group,repigmentation at 6 months postoperative was excellent in 77.5%versus 26.4%,good in 13.8%versus 18.1%,fair in 8.8%versus 19.4%,and poor in 0%and 36.1%.There was a positive correlation between the satisfaction of the patients in the new pigmentation spot group and the third-party assessor and repigmentation.ConclusionsThe blister grafting test and the emergence of new pigmentation spots are both effective screening methods of ReCell technology.Their appearance indicates that the efficacy of autologous non-cultured epidermal cell suspension in the treatment of stable vitiligo will be expected to increase.