Vitiligo patients gain long-term repigmentation benefits from MKTP surgery

In many patients with vitiligo, melanocyte-keratinocyte transplantation (MKTP) may provide long-term repigmentation for up to 72 months, according to study results published in the Journal of the American Academy of Dermatology.

During ‘skin transplant surgery,’ melanocyte skin cells are harvested from healthy, pigmented areas of the body, and transferred to areas without pigment. In about 2 months, pigmentation will begin to return in the transplanted area.

“MKTP works and it lasts a long time,” said senior author and principal investigator Iltefat Hamzavi , MD, dermatology, Henry Ford Hospital, Detroit, MI. “It’s better than any technology we have to treat this condition.”

Henry Ford Hospital was the first hospital in North America to perform MKTP, in 2009, when researchers demonstrated the MKTP was safe and effective for treating vitiligo, and restored pigmentation.

“We were the first North America center to show it works. Now we can show that not only does it work, it lasts for years in a majority of patients,” said Dr. Hamzavi, who has since then worked to refine the MKTP technique to maximize repigmentation potential. He currently uses a laser to remove white vitiligo lesions and prepare the skin for the transplant of healthy melanocytic cells, instead of a dermabrader, as initially used.

Dr. Hamzavi and colleagues conducted this retrospective review to assess long-term repigmentation of MKTP in patients with vitiligo and other leukodermas. They included electronic medical records for all MKTPs performed at Henry Ford Hospital from January 2009 to April 2014. Patient repigmentation was assessed using a 5-point grading scale as well as the Vitiligo Area Scoring Index (VASI).

In all, 100 patients underwent MKTP at 236 anatomically-based lesions (ABLs), of whom 63 with 157 ABLS had available long-term data (median: 24 months). Dr. Hamzavi and fellow researchers observed improvements in VASI scores in patients with segmental vitiligo (-75.6%), nonsegmental vitiligo (-59.2%), and physical leukoderma (-32.4%).

In addition, they found that greater than 75% ABL repigmentation was maintained in 53% of vitiligo patients 24 months after MKTP, in 64% at 48 months, and in 53% at 72 months. Outcomes of treatment were not significantly affected by skin phototype, age, or anatomic ABL location.

“If you pick the right patient, do the procedure properly – the majority of patients will maintain their color,” Dr. Hamzavi concluded.

This study was funded by Henry Ford’s Department of Dermatology.