Surgical Interventions for Patients With Vitiligo found to b
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Surgical interventions are a key part of the therapeutic arsenal, especially in refractory and stable vitiligo. A Study was conducted to investigate the reported treatment response following different surgical modalities in patients with vitiligo.
A total of 117 studies were identified in which punch grafting (n?=?19), thin skin grafting (n?=?10), suction blister grafting (n?=?29), noncultured epidermal cell suspension (n?=?45), follicular cell suspension (n?=?9), and cultured epidermal cell suspension (n?=?17) were used.

The primary outcomes were the rates of greater than 90%, 75%, and 50% repigmentation response. These rates were calculated by dividing the number of participants in an individual study who showed the corresponding repigmentation by the total number of participants who completed the study. The secondary outcomes were the factors associated with treatment response to the surgical intervention.

Results:
--Among the 117 unique studies and 8776 unique patients included in the analysis, rate of repigmentation of greater than 90% for surgical interventions was 52.69% and 45.76% for punch grafting, 72.08% for thin skin grafting, 61.68% for suction blister grafting, 47.51% for noncultured epidermal cell suspension, 36.24% for noncultured follicular cell suspension, and 56.82% for cultured epidermal cell suspension.

--The rate of repigmentation of greater than 50% after any surgical intervention was 81.01%. In meta-regression analyses, the treatment response was associated with patient age (estimated slope, ?1.1418), subtype of vitiligo (estimated slope, 0.3047), and anatomical sites (estimated slope, ?0.4050).

In conclusion, the results indicate that surgical intervention could be a successful option for stable refractory vitiligo. Depending on the age of the patient, the location and size of the lesion, and the cost, an appropriate treatment should be prescribed.

Source: https://jamanetwork.com/journals/jamadermatology/fullarticle/2776177
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