Dermabration followed by topical 5% 5-fluorouracil and autologous melanocyte transplantation in stable vitiligo

Context: Vitiligo is an acquired melanocytopenia of unknown etiology. Recent studies have shown that vitiligo areas contain dormant melanocytes which can be activated by exogenous and endogenous stimulation. Topical 5% 5-fluorouracil after dermabrasion and autologous melanocyte transplantation are two different methods of surgical management in stable vitiligo lesions refractory to medical treatment.
Aim: To compare the efficacy of topical 5% 5-fluorouracil after dermabrasion and autologous melanocyte transplantation in repigmentation of stable vitiligo lesions.
Settings and Design: At Tertiary care center, Skin opd, GNDH Amritsar, A Randomised Prospective interventional trial.
Methods: Forty stable vitiligo lesions in 20 cases of localized stable vitiligo patients not responding to medical treatment were selected and randomised into two groups. Group A lesions (n=20) were subjected to dermabrasion followed by 5% 5-FU application and Group B lesions (n=20) were subjected to dermabrasion followed by melanocyte transplantation by autologous noncultured epidermal suspension (NCES). Follow up was done at 4, 8, 12 weeks of procedure to assess the repigmentation achieved.
Statistical analysis used: Data were analyzed statistically by applying student test (t) (unpaired) &Wilcox an Signed Rank test.
Result: Patients included in the study belonged to different strata of society. Their age varied from 18-40 years and the male and female ratio was 1:3. At the end of the study, more than 75% repigmentation in 3/20 (15%) lesions in group A and 10/20 (50%) lesions in group B was achieved. There was no complication with any method. Statistically, the difference in the repigmentation by two methods was significant.
Conclusion: Topical application of 5% FU is easy to perform, does not require much expertise and is relatively inexpensive. Though noncultured autologous grafting is a novel surgical method of cellular transplantation it requires trained personnel and laboratory facilities.