Cell transplants restore lost skin color

Transplantation of pigment-producing cells called melanocytes appears to be a safe and effective treatment for vitiligo, in which patches of skin lose their coloration, appearing whitish, according to two reports in the Archives of Dermatology.

The usual treatment for vitiligo, one of the most common pigment disorders, using ultraviolet light and steroids is often unsuccessful, Dr. Nanny van Geel and colleagues at Ghent University Hospital in Belgium point out.

The researchers conducted a study in which grafts containing melanocytes were transplanted in 19 patients with vitiligo whose disease had been stable for at least 12 months, and 9 others with more unstable disease. For comparison, some of the patient's vitiligo lesions were given inactive "placebo" treatment.

The procedure involves taking a thin layer of normally pigmented skin from the patient's "gluteal region." Melanocytes are then separated out and used to make a cellular suspension. The area to be treated is ablated with a laser, and the melanocyte graft applied. Three weeks later, the area is exposed to UV light repeatedly for two months.

After 3, 6 and 12 months, the lesions treated with the melanocytes showed a much greater improvement in skin coloration than those treated with placebo. Neither therapy was particularly effective in patients with unstable disease.

In another test, Dr. Sanjeev V. Mulekar, at the Noble Clinic in Pune, India, used a similar technique in 64 patients with vitiligo. Unlike the first study, all of the subjects had stable disease.

Between 73 and 84 percent of patients experienced nearly complete repigmentation of their skin. Moreover, in some cases, this lasted for up to five years after treatment.

"Patients with...vitiligo can experience a long disease-free period, which may extend through the rest of their lives," Mulekar concludes.

"If used for the appropriate indications and in the right circumstances, surgical treatments represent an important strategy to restore pigmentation in skin that has lost its melanocytes, and it will most likely continue to serve this purpose for many more years," Dr. Mats J. Olsson, a dermatologist at Uppsala University in Sweden, comments in an accompanying editorial.

SOURCE: Archives of Dermatology, October 2004.