自体培养黑素细胞移植治疗生殖器部位白癜风

Autologous cultured melanocyte transplantation for the treatment of genital vitiligo

目的探究自体培养黑素细胞移植治疗生殖器部位白癜风患者的疗效。方法回顾分析2013-2016年杭州市第三人民医院皮肤科采用自体培养黑素细胞移植治疗生殖器部位白癜风的6例患者,年龄13 ~ 29岁,发病年龄10 ~ 19岁,病程2 ~ 10年,生殖器部位白斑面积10 ~ 25 cm^2.6例移植前白斑稳定时间均超过12个月。移植后2周,移植处伤口结痂脱落后开始使用吡美莫司每天2次。白斑复色达90%以上时,改为吡美莫司每3天1次维持治疗。自体培养黑素细胞移植治疗后,随访观察至少24个月,最长60个月。结果自体培养黑素细胞移植治疗后2个月,6例皮损均有色素产生,其中3例复色80%,2例复色70%, 1例复色50%。移植后6个月,3例复色达95%,2例复色80%, 1例复色仍为50%。移植后12个月,3例复色仍为95%,2例复色80%的患者皮损复色面积上升为90%, 1例复色仍为50%,此结果持续至随访结束,复色的色素基本正常。随访期间无不良反应。结论自体培养黑素细胞移植对处于稳定期的生殖器白癜风具有较好的疗效。

Objective To evaluate the efficacy of autologous cultured melanocyte transplantation in the treatment of genital vitiligo. Methods A retrospective analysis was carried out. From 2013 to 2016, 6 patients with genital vitiligo were enrolled from Department of Dermatology, Hangzhou Third People' s Hospital, who received the treatment with autologous cultured melanocyte transplantation. These patients aged 13-29 years, and the age of onset and disease duration ranged from 10 to 19 years and 2 to 10 years respectively. The area of white patches at the genital site ranged from 10 to 25 cm2. Before the transplantation, all the white patches of the 6 patients bad been stable for > 12 months. Two weeks after the treatment, pimecrolimus was applied to the wounds twice a day after crust shedding. When the patient achieved > 90% repigmentation of the white patches, pimecrolimus was applied once per three days for maintenance treatment. After the treatment, these patients were followed up for at least 24 months, and the longest follow?up period was 60 months. Results Obvious pigmentation was observed in all the 6 patients 2 months after the transplantation. Meanwhile, 3 patients achieved 80% repigmentation, 2 achieved 70% repigmentation, and 1 achieved 50% repigmentation. Six months after the treatment, 3 patients achieved 95% repigmentation, 2 achieved 80% repigmentation, and 1 still maintained 50% repigmentation. Twelve months after the treatment, 95% repigmentation was still maintained in the 3 patients, 90% repigmentation was achieved in 2 patients, and 1 patient maintained 50% repigmentation, and these outcomes lasted until the end of follow - up. During the follow-up, no adverse reactions were observed. Conclusion Autologous cultured melanocyte transplantation is effective for the treatment of stable genital vitiligo.