Long-term follow-up of leucoderma XXXX treated with transplants of autologous cultured melanocytes, ultrathin epidermal sheets and basal cell layer suspension.

@entity1 @entity1375 @entity66 @entity2117 @entity19016 @entity1694
BACKGROUND: In @entity1694 and @entity19016 the lack of melanin in the epidermis is due to the fact that melanocytes are missing. The @entity1 suffer psychologically and the white areas have lost the part of the skin barrier protection normally provided by the melanocytes. Medical treatments are ineffective in many of the @entity1 , and surgical methods have therefore been developed. OBJECTIVES: It is important to investigate the long-term results and factors that might influence the outcome of melanocyte transplantations in order to form a basis for guidance in the selection of @entity1 who will benefit most from the treatments. METHODS: A follow-up of 132 @entity1 who had been treated by transplantation on 176 occasions in total, 1-7 years previously, was carried out by questionnaires and clinical examinations. We investigated the responses in five types of leucoderma to three different transplantation methods: autologous cultured melanocytes, ultrathin epidermal sheets and basal layer cell suspension. RESULTS: Stable types of leucoderma, i.e. segmental @entity1694 and @entity19016 , responded in most cases with 100% repigmentation, regardless of the surgical method used. For these types of leucoderma surgery seems to be the method of choice. The largest group, @entity1694 , was thoroughly scrutinized and three statistical models were used to analyse the data. The ultrathin epidermal sheet method gave somewhat better overall results, but was the method that gave the worst outcome in knee and elbow areas, emphasizing the importance of the right choice of method depending on the anatomical location to be treated. Irrespective of the method, fingers and elbows were the most difficult areas to repigment. The trunk and the arms and legs (not including elbows and knees) responded best. @entity1 with increasing and/or extensive @entity1694 more often showed incomplete repigmentation. They also had a lower chance of retaining their repigmentation compared with those with less extensive @entity1694 . @entity1 in whom untreated white lesions had increased in recent years tended to respond less well to transplantation compared with @entity1 with unchanged or decreased lesions. Within the @entity1694 group, @entity1 with @entity66 duration or with small total @entity1694 area responded best to transplantation. The subgroup of @entity1694 @entity1 with @entity1375 tend to respond less well to the transplantation and they were generally older at @entity1694 onset. This information is of great importance for the selection of @entity1 and when informing about the chances of improvement after transplantation. @entity2117 was common, especially when ultrathin epidermal sheets had been used. No scars or indurations were seen in treated areas. CONCLUSIONS: Transplantations are the methods of choice in stable types of leucoderma. Progressive, widespread @entity1694 should never be selected for transplantation.
