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Punchgrafting for vitiligo

Punchgrafting for vitiligo

Vitiligo is a chronic skin disorder that causes areas of skin to lose colour. It presents as depigmented (white) patches.
Exposed body sites, such as the face, elbows, knees, hands and feet, are often involved, resulting in significant cosmetic concerns.
Vitiligo is usually treated with creams and tablets, or by light therapy.Vitiligo may fail to improve or clear with these treatments.
Surgical treatment options can be considered in patients with stable vitiligo.

The aim of the surgical treatment for vitiligo is to transfer melanocytes (pigment-producing cells) from normal skin (the donor site) to the skin affected by vitiligo to regain the normal skin colour.

Miniature punch grafting

Miniature punch grafting is one of the most commonly used techniques, due to its simplicity and efficacy.

Procedure

Under local anaesthesia bits of skin about 2 mm in diameter are punched out from the donor site such as from buttock or thigh .On the recepient site chambers are created by puches and bits of skin from donor area are grafted on the donor site of vitiliginous skin.

Immediate complications of miniature punch grafting include:
• Loss of graft tissue
• Infection

Mid to longterm complications of miniature punch grafting include:
• Hyperpigmentation
• difference in colour with the surrounding skin
• Peripheral depigmentation (halo effect)
• Graft rejection
• keloid or hypertrophic scar at the donor or graft site
• Cobblestone appearance at the recepient site
• Persistent vitiligo

Summary

Punch grafting is generally safe, easy to perform and inexpensive, with good success rates. However, it can also be very time consuming, and can be performed only on small areas of skin.

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