DS13 A comparative study between recipient site preparation using manual dermabrasion and tattooing pen in autologous noncultured epidermal cell suspension procedure in stable vitiligo patients: a randomized double blinded study

Abstract Vitiligo is a common acquired disorder of depigmentation that occurs as a result of melanocyte loss. Surgical therapies are indicated in patients with stable disease who fail to respond to medical therapies. This mostly includes autologous grafting techniques both tissue and cellular (both cultured and noncultured). Common techniques of recipient site preparation include dermabrasion, suction blistering, liquid nitrogen, electrofulguration and microneedling. The aim was to assess the difference in extent of repigmentation with manual dermabrasion and tattooing pen in a noncultured epidermal cell suspension on stable vitiligo patches. This was a prospective intraindividual comparative study. Thirty-six patients with stable vitiligo were recruited. Patients had a clinical diagnosis of segmental or nonsegmental vitiligo and had two independent patches of 3 × 3 cm or more present either symmetrically or unilaterally over the same body site or a single patch of 6 × 6 cm or more. Vitiligo lesions had been stable for ≥ 1 year. At week 24, the proportion of patients achieving > 75% repigmentation with manual dermabrasion was 86%. In contrast, 61% of patients in the tattooing pen group achieved > 75% repigmentation. At week 24, the proportion of patients achieving > 50% repigmentation with manual dermabrasion was 89% vs. 72% of patients in the tattooing pen group. Eighty per cent of patches at acral sites in patients in the manual dermabrasion group achieved > 75% repigmentation vs. 94% in nonacral patches, whereas in the tattooing pen group, 47% of patches at acral sites achieved > 75% repigmentation vs. 73.3% in nonacral patches. In terms of colour matching, at 24 weeks, good colour matching with the surrounding normal skin was obtained in 80% of patches in both groups. There was a significant difference in efficacy between the two methods in favour of manual dermabrasion. Tattooing pen for melanocyte delivery has the advantage over manual dermabrasion in that it is less time consuming and also reduces cell loss. Recipient site preparation by manual dermabrasion showed a higher rate of infection vs. the tattooing pen at 4 weeks (25% vs. 6%). Recipient site preparation in terms of colour matching and halo phenomena was comparable in both the groups, with no significant difference seen. Patient satisfaction in terms of physician global assessment score and Vitiligo Quality of Life index (VitiQoL) was comparable for both methods, with no significant difference seen.