Surgical Management of Vitiligo

Although vitiligo has traditionally been very difficult to treat, a new breakthrough surgical treatment is expanding options for practitioners and patients.

Standard treatments depend on the severity of the condition and the patient's feelings of disfigurement. Cover-up cosmetics work well for some people. Other more sophisticated forms of treatment include gradually developing color back in the depigmented areas (repigmentation) by PUVA or other ultraviolet light treatments, but this is extremely slow and intensive, often requiring several hundred treatments.

This new form of treatment, which involves surgically transplanting melanocytes into the white areas, is most successful in patients with stable vitiligo over less than 30% of their body surface area. It complements medical therapies in achieving complete and sustained repigmentation and is rapidly gaining popularity in all major centers.

This is the first book available which describes this major advance in detail.

Explains the new treatment of surgically transplanting melanocytes into the affected areas of the skin to provide dermatologists and surgeons with the latest state-of-the-art information
Written by the international leaders who pioneered this treatment
Presents all the latest information on the topic, eliminating the need to search through multiple sources for specific data

Table of Contents

Section 1

Pathogenesis and medical treatment
1 Pathogenesis of vitiligo
2 Understanding the mechanism of repigmentation in vitiligo
3 Classification of vitiligo
4 Medical treatment of vitiligo

Section 2

Overview of surgical management
5 History and chronology of development of surgical therapies for vitiligo
6 The concept of stability of vitiligo
7 Patient selection and preoperative information in surgical therapies for vitiligo
8 Classification of surgical therapies for vitiligo
9 Surgical management of vitiligo and other leukodermas: evidence-based
practice guidelines
10 Evaluation of outcome in surgical therapies for vitiligo

Section 3

Tissue grafting
11 Minigrafting for vitiligo
12 Suction blister epidermal grafting
13 Thin split-thickness skin grafts for vitiligo
14 Treatment of leukoderma by transplantation of ultra-thin epidermal sheets
15 Transplantation of hair follicles for vitiligo
16 Mesh grafts for vitiligo
17 Flip-top pigment transplantation
18 Ultrasonic abrasion and seed grafts for vitiligo
19 Complications and limitations of melanocyte transplantation

Section 4

Cellular grafting
20 Treatment of leukoderma by transplantation of basal cell layer suspension
21 Setting up a tissue culture laboratory
22 Treatment of leukoderma by transplantation of cultured autologous
melanocytes
23 Transplantation of in vitro cultured epithelial grafts for vitiligo and
piebaldism
24 Simplifying the delivery of cultured melanocytes and keratinocytes for
grafting patients with vitiligo
25 Safety concerns in transplantation of in vitro cultured cellular grafts

Section 5

Special issues
26 Post-surgery patient information
27 Surgical management of lip vitiligo
28 Surgical management of vitiligo of eyelids and genitals: special issues
29 Surgical management of acral vitiligo
30 Surgical management of leukotrichia
31 Surgical treatments of leukodermas other than vitiligo vulgaris

Section 6

Miscellaneous
32 Micropigmentation
33 Laser for repigmenting vitiligo
34 Application of lasers in transplantation procedures for vitiligo
35 Combining medical and surgical therapies
36 Surgical depigmentation of vitiligo: bleaching cream, laser and cryosurgery
37 Future directions in surgical management of vitiligo
38 Informed consent