Personalized Treatment for Vitiligo

• Vitiligo is one of the common depigmentary disorders that remains one of the major dermatological challenges. 
• It affects approximately 1% of the world’s population and affects all races and has a long history.
• Vitiligo causes various psychological problems leading to reduced self-esteem, confidence, stress, depression and even suicidal tendencies due to various social problems associated with it. 
• Vitiligo surgery is an important, but under- performed, treatment in vitiligo 
• In view of multiple hypothesis behind the pathogenesis of vitiligo, proper treatment modality is not been established. 
• The response to medical line of treatment is 30%. 
• Surgical management may be the ray of hope in remaining patients if the vitiligo is stable. 
• Stable vitiligo amenable to surgical modality of treatment depends on the site, age, stability of the disease.

PRINCIPLE OF VITILIGO SURGERY

• All surgical techniques for vitiligo rely on the one basic principle 
• When melanocyte reservoir is lost in the epidermis, repopulating with functional Melanocytes from normally pigmented epidermis or hair follicles. 
• The Melanocytes which have been introduced will then establish and function as epidermal melanin units.

PROCEDURE of Vitiligo Treatment in Jayanagar at Epiderma Clinic:

1. As a rule, covered areas such as gluteal region or the thigh are preferred since there is always a risk of pigmentary changes occuring at the donor site.
2. Punch grafts (of 1.2-2.0 mm diameter) are taken from donor areas over the thighs, buttocks, postauricular areas/ posterior earlobe or the medial aspect of the upper arm. These are grafted into recipient sites in stable vitiligo lesions. Sockets are created in the recipient area at a distance of 5-10 mm and the harvested grafts are placed in these sockets.
3. This allows the perigraft spread of pigment to cover the surrounding depigmented skin.
4. Dressings are postoperatively placed to ensure immobilization, and may be removed in 24 hours to check for the displacement of the grafts.
5. Grafts are taken up in 7-10 days after which phototherapy or treatment with topical steroid is started to ensure even spread of perigraft pigment.