Vitiligo, which is difficult to treat, catches with skin grafting
Input: 2022-10-10 18:23:46
Byung-gun Kim, Senior Correspondent [email protected]
Transplanted into the affected area of the microscopic skin tissue behind the ear
Innovative treatment with reduced surgery time and side effects
Rise as a ‘game changer’ for intractable diseases
A technique discovered by chance during a hair transplant
When combined with laser treatment, the effect increases
Park Geun, the director of Centum Mobix Dermatology, is performing a ‘microperforated skin grafting technique’ by collecting normal skin behind the ear with an electric punch and transplanting it to the site of vitiligo. Provided by Centum Dermatology Clinic
Advances in medicine are sometimes made by accidental discoveries. The discovery of penicillin in mold and aspirin, which started as a fungicide, are similar cases.
The treatment of vitiligo using hair transplantation, which has been recently introduced in the dermatology world, can be said to be a medical technique discovered with unexpected luck. I found out that I had a hair transplant for hair loss patients, but it was an unexpected treatment for vitiligo.
The vitiligo that plagued the ‘King of Pop’
World-famous pop singer Michael Jackson suffered from vitiligo. Michael Jackson was once plagued by rumors of overdoing her makeup to look white. However, his skin turned white because he was a vitiligo patient, not because he had intentionally removed the pigment to change his skin color. So he always wore sunglasses, a hat, and an umbrella to protect his skin from UV rays.
Vitiligo is a disease in which melanocytes in the skin suddenly disappear. White spots of various shapes appear all over the body, including the face and neck. One or two white spots may appear locally, or symmetrical or asymmetrical spots may occur sporadically.
In most cases, there are no specific symptoms other than the loss of pigment. Sometimes, when vitiligo is about to get worse, it is accompanied by itching. Although it is not a pain or life-threatening disease, it often suffers psychologically and socially due to cosmetic problems.
It is a relatively common disease, affecting around 1% of the world’s population. Although the exact cause of the disease is not known, it is presumed that the cause is the death of melanocytes due to oxidative stress and autoimmunity caused by an increase in the amount of free radicals in the body.
Director Park Geun of Centum Mobix Dermatology Clinic said, “Vitiligo does not interfere with daily life, but the patient’s stress is enormous because white spots are exposed. If treatment is started early, the prognosis is good.”
No longer an incurable disease
Vitiligo treatment says it takes patience. It is known that the therapeutic effect is slow. As it is a type of autoimmune disease, there is still no suitable treatment for it.
In the early stages of the onset, the range is small and can be treated in a short period of time. However, if a certain amount of time passes and the range increases, the treatment period will inevitably be longer.
Treatments vary. In the past, UVB ultraviolet light therapy was used, but it is very inconvenient because it enters the cylinder and receives treatment. These days, excimer laser treatment, which is more effective, is the mainstay. Excimer laser can selectively treat only the affected area, so there is no side effect of turning normal skin black.
However, although UV light therapy or excimer laser therapy improves to some extent, the effect varies from patient to patient. In addition, there are many cases in which vitiligo has already progressed to an area that does not improve even after several years of treatment.
Director Park Geun said, “Vitiligo often does not get better even after months or years of treatment. As it is recognized as an intractable skin disease, patients often give up treatment midway. However, with the recent application of skin graft surgery, dramatic treatment results are being introduced one after another,” he said.
Micro-perforated skin graft, vitiligo game changer
In the early 1990s, a paper was published in Korea that said that vitiligo can be cured by hair transplantation in the intractable vitiligo area. It was a very innovative treatment at the time.
However, since there was only an incisional surgical method in which the bed was removed and hair transplanted, the burden of the operation was severe. In addition, they had to go through a manual process of transplanting hairs one by one on the vitiligo skin, and hair grew from the vitiligo lesion, so hair removal had to be done again. In the end, despite its excellent effect, it was ignored in the clinical field.
After that, suction epidermal grafting was also introduced, which took a long time and was accompanied by severe pain. The disadvantage was pointed out that the procedure is difficult for curved skin, and even if the transplant is successful, excessive pigmentation occurs occasionally. This is a surgical procedure that involves forcing blisters on normal skin, then taking a thin piece of skin of a certain size and transplanting it to the vitiligo area.
Meanwhile, micro-perforated skin graft using an electric punch has recently emerged as a game changer for vitiligo treatment. It is possible to obtain miraculous therapeutic effects, while solving various side effects such as surgery time, pain, and hyperpigmentation.
Micro-perforated skin grafting is a so-called non-incisional hair transplantation surgery in which hair follicles are pulled out one by one using a 1.0mm punch and transplanted. To facilitate this operation, an electric punch rotating at 3000 rpm is used to obtain the skin to be transplanted. Using this machine, microscopic skin with a size of 0.4mm can be easily harvested and transplanted without damage.
Instead of collecting hair follicles from the scalp, transplant skin is collected from behind the ears. The concept is that if skin tissue with a size of 0.4 mm is collected as a ‘seed’ from skin with skin color and transplanted into a vitiligo lesion, the melanocytes in the ‘seed’ spread and vitiligo is cured.
Director Park Geun said, “Unlike the existing epidermal transplantation, the procedure time is relatively short and there is little bleeding or pain. It can also be transplanted to joints or curved surfaces,” he explained.
The micro-perforated skin graft has been recognized as effective in the treatment of intractable vitiligo, and as health insurance has recently been applied, the burden on patients has been greatly reduced. Laser treatment after skin grafting can further enhance the treatment effect.
Byung-gun Kim, Senior Correspondent [email protected]