In study data published in Dermatological Treatment. In a randomized clinical trial of patients undergoing non-cultured epidermal cell suspension (NCES) for vitiligo, site preparation with dermabrasion or cryoblast techniques was associated with good repigmentation results and high patient satisfaction. Dermaroller preparation had poor repigmentation compared to the other techniques.
Although NCES is an established form of vitiligo treatment, the optimal method of preparing the recipient site remains unclear. To compare the relative effectiveness of common preparation methods, researchers recruited vitiligo patients from a dermatology clinic in Chandigarh, India, from June 2018 to June 2019. Patients with at least 3 vitiligo patches in the same anatomic site of their choice to submit to NCES was registered.
Patients underwent 3 methods of site preparation on at least 3 separate lesions prior to NHS: dermabrasion, cryoblister, and dermoid. After NCES, participants were followed up at 4, 8, and 12 weeks after the procedure. Primary outcomes were site repigmentation, color matching, and patient satisfaction.
The study cohort included 36 patients, of whom 22 were women. The mean age at enrollment was 28.33 (±9.4) years. Mean disease duration was 10.06 (±5.3) years. The mean surface area treated per patient was comparable between the 3 preparation methods: 3.7 (±1.4) cm2 with skin scraping; 3.5 (±1.2) cm2 with cryoblister; and 3.1 (±1.4) cm2 with a dermaroller.
At 12 weeks, dermabrasion and cryoblasting had comparable efficacy with respect to the extent of repigmentation. Specifically, 55.6% and 47.2% of lesions treated with dermabrasion and cryoblister had achieved greater than 75% repigmentation, respectively.Pi =.63). Furthermore, patient satisfaction scores were similar for lesions treated with dermabrasion and lesions treated with cryoblister (20.2±9.6 vs 19.9±7.9 of 30.0; Pi =.194).
However, dermabrasion had a superior rate (65% vs. 32.5% repigmentation at 4 weeks. Pi =.04) and color matching (47.2% vs. 19.4%; Pi =.004) compared to cryoblister. Also, hyperpigmentation was observed in 72.2% of patches treated with cryoblister, compared to only 33.3% of dermabrasion patches.
Dermaroller had poor repigmentation, speed and color matching results compared to both dermabrasion and cryoblister.
Based on these results, cryoblister and dermabrasion appear equally effective methods of NCES preparation in terms of repigmentation and patient satisfaction. However, cryoblister was associated with a higher risk for repigmentation. Dermaroller had inferior results compared to the other 2 methods.
The researchers cited the small sample size and short follow-up period as limitations of the study. Further research is needed to better elucidate the effects of different recipient site preparation methods.
“This study established both dermabrasion and cryoblast as equally effective pre-NCES vitiligo patch preparation techniques, producing rapid repigmentation (<12 weeks) with good color match even in difficult-to-treat areas," the researchers wrote. "Therefore, in stable patients with vitiligo, both dermabrasion and cryoblast can be used to prepare recipient sites in the NHS."
Report
Subburaj K, Thakur V, Kumaran MS, Vinay K, Srivastava N, Parsad D. A prospective, randomized clinical study to compare the efficacy of recipient site preparation using dermabrasion, cryoblister, and dermaroller in autologous uncultured epidermal cell suspension in stable vitiligo. Published online on December 19, 2020. Dermatol Ther. doi:10.1111/dth.14683
