VITILIGO SURGERY

In India, vitiligo is considered a social stigma and afflicted patient and his family ostracised, hence it is important for dermatologist to completely cure the patient. Sometimes patients are not responding to all the possible medical therapies or responding very slowly in this case surgery is necessary. Indication for surgery: Patients not responding to adequate trial of medical line of treatment.

Vitiligo lesion should be strictly stable for minimum of two years

MINIATURE PUNCH GRAFTING

It is carried out under local anaesthesia and consists of thin punch grafts of sizes 1.5,2 or 2.5 mm with minimised cylindrical skin biopsy punches. They area removed from pigmented donor site & individually grafted in the appropriate punch out chambers, spaced 5 to 10 mm apart at vitiligo site Once the grafts are 'taken up' the patient is advised to take PUVA or PUVA SOL. Repigmentation occurs in 3 - 6 months and good cosmetic result is obtained. Antibiotics, anti inflammatory drugs are taken for seven days.

Exposures to natural sunlight, UVA after the grafts are taken up till repigmentation.

OTHER SURGICAL MODALITIES FOR VITILIGO

• Cosmetic tattooing
• Thin thiersch's graft.
• Excision and closure.
• Suction blister technique.
• Therapeutic wounding-dermabrasion,laser ablation, LN2 cryosurgery,phenol or TCA applicatiom, needling ect.
• Ultra thin grafting.

Grafting of non-cultural epidermal suspension.
Skin cultures, Trypsinized auto graft injection, single hair transplant homologous grafting etc.