Autologous cell suspension grafting in segmental vitiligo and piebaldism: a randomised controlled trial comparing full-surface and fractional CO2 laser recipient site preparations

Summary

Background

Autologous non-cultured cell suspension transplantation is an effective treatment for repigmentation in segmental vitiligo and piebaldism. Full surface laser ablation is frequently used to prepare the recipient site before cell suspension transplantation, even though optimal laser settings and ablation depth are unknown.

Objectives

To assess the efficacy and safety of less invasive recipient site preparations.

Methods

In a randomised, observer-blinded, controlled trial we compared different recipient site preparations before cell suspension transplantation in segmental vitiligo and piebaldism. In each patient, we randomly allocated three CO₂ laser recipient site preparations (i.e. 209 and 144 μm full surface, fractional) and a control (no treatment) to four depigmentations. After six months we assessed repigmentation and side effects.

Results

We included 10 patients with vitiligo (n=3) and piebaldism (n=7). Compared to the control site, we found more repigmentation after 209 μm (median 68.7%, p=0.01) and 144 μm (median 58.3%, p=0.007) full surface ablation, but no repigmentation after fractional ablation (median 0.0%, p=0.14).

Conclusion

Superficial full surface ablation with a depth of 144 μm is an effective recipient site preparation before cell suspension transplantation while fractional CO₂ laser is not. #NCT02458417.

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