Central Asian Journal of Medicine


Background. Vitiligo is an acquired and most common pigmentary disorder of polygenic multifactorial inheritance. To date it is the most frequent cause of depigmentation worldwide. Vitiligo mainly affects melanocytes from epidermis basal layer, and the typical presentation is a progressive depigmentation of the skin and mucous membranes due to melanocyte disappearance. Until now the pathogenesis of vitiligo has not been totally determined and many theories have been proposed. Of these, the autoimmune hypothesis is now the most studied and discussed among researches. Dysfunction in metabolic pathways, which could lead to production of toxic metabolites causing damage to melanocytes, has also been investigated. However vitiligo is easy to diagnose, but characterized by specificity in terms of the treatment complexity. This paper deals with modern approaches in the surgical treatment of vitiligo. Research objective: to study and evaluate the efficacy of the vitiligo therapy based on the localization of the disease process. Materials and methods. The research included 345 patients categorized by three age groups: 18 to 40 years old, 41 to 60 years old, and 60 years old and older. Clinically, 121 (35.1%) patients had segmental vitiligo (70 women and 51 men), and 224 (64.9%) patients were with non-segmental vitiligo (124 women and 100 men). Vitiliginous depigmented patches were studied according to their location on the body areas: face, trunk, hands and arms and legs. A mixture of hair follicle cell suspension (NCECS + NCORSHFS), obtained from the scalp of a patient with vitiligo, was applied with the mixture of the suspension of non-cultivated epidermal cells (NCECS) and the suspension of non-cultivated epidermal cells. During the research we used the high-technology apparatus “Regenera” (Italy), the action of which was to extract the mesenchymal cells of the hair follicle and to transplant the obtained material together with functionally active melanocytes into the depigmented skin of vitiligo patients. Findings. The study showed that both methods proposed in the research had a high efficacy in repigmentation process of facial area; the significantly higher level of repigmentation on arms and legs compared to NCECS was achieved when treated with NCECS + NCORSHFS method. The study established that a high repigmentation can be achieved by choosing the treatment method depending on the location of depigmented patches on the body areas. The performed method of surgical treatment of vitiligo is highly effective, which is confirmed by the absence of signs of depigmentation after the end of the course of treatment. The recommended course of treatment with this surgical method is 1-3 procedures, depending on the location and volume of the pathological process. Application of the NCECS+NCORSHFS method promotes faster repigmentation, eliminating cosmetic defects in patients, and improving their quality of life.

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