地塞米松合自体表皮细胞移植治疗进展期白癜风

白癜风是一种常见的碍容性皮肤病，其发病机理复杂，易诊难治。对稳定期白癜风的治疗，由于移植表皮成活率高、见效快，已成为我国治疗白癜风的一种流行方法，而临床上进展期白癜风患者要求行自体表皮细胞移植术者也较多。笔者于2000年9月-2003年12月用激素冲击治疗进展期白癜风稳定病情后，再行自体表皮细胞移植治疗32例进展期白癜风患者，取得了较好疗效，现报道如下。     

射频技术在自体表皮移植治疗白癜风中的应用研究

目的：探讨射频技术在自体表皮移植治疗白癜风中的应用价值,从而寻找一种在自体表皮移植治疗白癜风中处理白斑区的有效方法。方法：选择35例稳定期白癜风患者,用射频技术处理白斑区,使之形成新鲜创面,而后行表皮细胞移植。结果：用射频技术治疗白癜风患者35例,移植皮片182片,其中痊愈142片（占78.02%）,显效27片（占14.84%）,有效11片（占6.04%）,无效2片（占1.10%）,总有效率92.86%。结论：射频技术处理白癜风皮损区表皮方便、灵活、精细且准确,创面新鲜、平坦,有利于移植皮片成活。     

自体表皮细胞悬液在修复皮肤组织缺损创面中的作用研究

目的:探讨自体表皮细胞悬液在修复皮肤组织缺损创面的作用。方法:在20只大鼠身上分别取邮票大小自体全厚皮片进行消化,分离成单个表皮细胞的悬液;经传代培养后,使用自体表皮细胞悬液分别对20只大鼠背部表皮皮肤缺损创面进行覆盖移植,术后观察移植物成活率和植皮区收缩率,同时取移植物进行组织学观察;并与对照组20只自体愈合创面进行相互比较。结果:表皮细胞悬液移植后1周渐融合成片,伤口愈合;经6周后,伤口平整,轻度瘢痕愈合。而对照组在6周时伤口不平整,呈瘢痕愈合,色素沉着明显。结论:在表皮缺损创面上应用体外培养的自体表皮细胞悬液移植修复可达到重构皮肤的目的。     

自体黑素细胞培养移植治疗肢端型白癜风及相关因素分析

白癜风是一种常见的色素脱失性皮肤病,病因复杂,治疗困难,肢端型白癜风治疗更困难[1-2].自体黑素细胞培养移植是治疗白癜风的一种有效方法,近年来国内外陆续有不少使用该方法成功治疗白癜风的报道[3-7].我们在先前的黑素细胞培养的基础上[s],对培养基和方法进行了改进和规范,检测和计算了黑素细胞的分裂时间(DOT)、黑素含量(M)和黑素制造量(MP),同时用在体外培养的自体纯黑素细胞悬液进行移植治疗了38例67处皮损肢端型白癜风,效果良好.     

ReCell技术治疗稳定性白癜风的临床疗效

目的探索ReCell技术治疗稳定性白癜风患者的疗效。方法对6例白癜风患者应用ReCell技术治疗,于病变外围切取少量厚度为0．2mm的刃厚皮片,将其置入ReCell试剂盒内酶解后,形成表皮细胞悬液。病变部位应用微型动力系统磨削后,创面喷洒制备的表皮细胞悬液,加压包扎。结果平均随访6个月。5例寻常型白癜风患者出现不同程度的色素恢复,色素恢复面积均〉50％。l例泛发型白癜风患者治疗无效。结论ReCell技术是治疗白癜风的有效外科方法之一。为了获得良好的治疗效果,适应证的选择非常关键。     

薄层削片法自体表皮移植治疗白癜风37例

目的：观察采用超脉冲CO2激光磨削皮损区后移植薄层削片法获得的自体表皮移植治疗白癜风的疗效。方法：37例患者采用超脉冲CO2激光磨削皮损区后移植薄层削片的自体表皮,观察表皮移植后的疗效。结果：37例患者移植皮片共132片,其中痊愈42片,占31．8％;有效88片,占66．4％;无效2片,占1．8％,总有效率为98．2％。结论：采用超脉冲CO2激光磨削皮损区后移植薄层削片法获得的自体表皮治疗白癜风较为简便有效。     

自体表皮移植加红霉素软膏治疗白癜风稳定期疗效观察

白癜风是一常见色素脱失性皮肤病,以表皮和毛囊色素细胞破坏为特征,临床易诊难治,目前自体表皮移植是效果较肯定的一种方法,但移植皮片成活率受多种因素的影响,如何提高皮片的成活率是治疗成功的关键。我们采用自体表皮移植加外涂红霉素软膏治疗稳定期白癜风,取得满意疗效,现报道如下。     

文饰遮色术治疗多发性白癜风1例

白癜风作为一种皮肤病变,目前尚无特效治疗方法。目前采用自体表皮移植法取得了较好的临床效果。但对有些病例仍很难达到满意治疗效果。我科遇到1例青年女性多发性白癜风患者,皮损面积较大,曾在外院行自体表皮移植术,术后供皮区皮肤并发白癜风,受皮区也未获得好的治疗效果,患者精神抑郁,丧失了生活的信心。我科采用文饰遮色术尝试[1]治疗患者局部色素缺失区,取得了良好的临床效果。1材料与方法1.l配色患者皮肤白癜风发病部位不同,故应根据各部位肤色深浅不同,分别配制相应的色料。取文利液中的自然灰、白色及少量土黄色进行调色,以白色为基…     

窄谱中波紫外线联合自体表皮移植治疗白癜风临床观察

目的:评价窄谱中波紫外线两种照射方法联合自体表皮移植治疗稳定期白癜风的临床疗效.方法:将患者分为三组,均接受自体表皮移植术治疗稳定期白癜风,治疗一组采用窄谱UVB术前(供皮区)、术后(受皮区)照射,治疗二组仅术后(受皮区)接受窄谱UVB照射,对照组单纯接受自体表皮移植术.结果:窄谱UVB配合自体表皮移植与单纯自体表皮移植治疗白癜风疗效差异有统计学意义(P相似文献   

自体表皮移植治疗白癜风疗效观察

白癜风是一种影响美观的难治性皮肤疾病,目前有效的治疗方法不多,我们用自体表皮移植的方法,对６２例白癜风病人共３２４区进行移植治疗,取得了一定的效果,现报道如下：１资料与方法１．１临床资料６２例白癜风均为门诊病人,男３２例,女３０例。年龄１０～６４岁。...     

Autologous Epidermal Cultures and Narrow-Band Ultraviolet B in the Surgical Treatment of Vitiligo

BACKGROUND: Vitiligo is an acquired skin disorder with a great social impact. It can be successfully treated with autologous epidermal grafting. OBJECTIVE: To evaluate the possibility of treating vitiligo by autologous grafting of epidermal cells and narrow-band ultraviolet B (UVB). METHODS: Autologous epidermal cultures were prepared starting from small biopsies of normally pigmented skin. Cells were cultured on hyaluronic acid membranes using medium supplemented with patient's serum. Cell cultures were grafted onto laser-abraded depigmented areas. Patients underwent narrow-band UVB therapy 3 weeks after grafting. RESULTS: Repigmentation of the grafted areas started 1 month after transplant and continued until 4 months after grafting. All patients were evaluated 3, 6, 12, and 18 months after grafting. At the 18-month follow-up, repigmentation was observed in 75% of patients with focal and segmental vitiligo and in 30% of patients with generalized vitiligo. CONCLUSIONS: This therapy can be considered for the treatment of stable vitiligo (especially focal and segmental) resistant to standard therapies. Their results are encouraging from the clinical and esthetic point of view, although the treatment is costly and highly specialized.     

节段型白癜风1000例临床特征分析

目的:总结及分析节段型白癜风的临床特征。方法:对1000例门诊节段型白癜风患者以调查问卷表形式进行资料收集,应用流式细胞术对部分患者外周血定量分析T淋巴细胞亚群,并应用SPSS19.0及Pri sm 5.0软件对资料进行统计、分析及绘图。结果:①节段型白癜风患者发病年龄平均(11.40±9.54)岁,74.4%的患者年龄小于14岁,皮损以面颈部好发,春夏两季多发;②与寻常型白癜风患者相比,节段型白癜风患者发病年龄更早,家族史少,伴发自身免疫相关疾病少;③与大于14岁的患者相比,儿童节段型白癜风患者皮损部位有或伴有白毛、白发的情况更多,伴发晕痣的情况较多见。结论:节段型白癜风的临床特征与寻常型白癜风有所不同,儿童节段型白癜风也有其临床特征。     

Suction Device for Epidermal Grafting in Vitiligo: Employing a Syringe and a Manometer to Provide an Adequate Negative Pressure

BACKGROUND: Suction devices for epidermal grafting need a suction pump to provide a negative pressure. The authors have developed a suction device in which a syringe and a manometer are employed to provide a negative pressure. OBJECTIVE: The purpose of this study was to evaluate the efficacy of our suction device in vitiligo patients. METHODS: The suction device was used to obtain epidermal blisters from the donor site. A CO2 laser was employed to remove the depigmented epidermis. The blister roofs of the donor site were harvested and were placed onto the recipient area. Ten patients with stable vitiligo were treated by epidermal grafting. RESULTS: Epidermal blisters were produced by suction in all patients. Also, all 10 patients regained repigmentation. CONCLUSION: Our suction blister device is simple and inexpensive to make, and it may become an alternative to the other suction devices.     

自体表皮移植治疗白癜风疗效观察

目的：观察自体表皮移植术治疗暴露部位白癜风的临床疗效。结果：32例患者共移植的300张表皮片,其中成活275张,总成活率为91.6％。结论：自体表皮移植术是治疗暴露部住白病民有效的方法之一。     

Suction Blister Epidermal Grafting Versus Punch Skin Grafting in Recalcitrant and Stable Vitiligo

BACKGROUND: Among various surgical therapies for replenishment of melanocytes in recalcitrant and stable vitiligo, punch skin grafting (PSG) and suction blister epidermal grafting (SBEG) are the simplest ones. Literature is lacking on a comparison of both. OBJECTIVE: We compared the results of both techniques in small patches of vitiligo. METHODS: Fifty stable vitiligo (focal, segmental, and generalized) patients were selected for study. One patient was lost to follow-up and excluded. PSG was done in 48 patches of 25 patients and SBEG was done in 38 patches of 24 patients. All patients were kept on psoralen ultraviolet-A (PUVA)/psoralen sunrays (PUVASOL). Results were evaluated after a follow-up of 4-7 months. RESULTS: Thirty-two (67%) patches of the PSG group and 31 (82%) patches of the SBEG group showed greater than 75% pigmentation. The difference in both groups was not statistically significant. Cobblestone appearance (23%) over the recipient area (RA) and superficial scarring of the donor area (DA) (100%) were seen in PSG. No serious complications were seen in both groups. CONCLUSION: Both techniques are simple and effective, however, SBEG gives cosmetically better and rapid results.     

Stable Vitiligo Treated by a Combination of Low-Dose Oral Pulse Betamethasone and Autologous, Noncultured Melanocyte-Keratinocyte Cell Transplantation

BACKGROUND: Various surgical procedures are in use to treat stable vitiligo. The possibility of Koebner phenomenon always exists with surgical treatment. Partial or complete failure to repigment is observed in spite of clinical stability. AIM: To evaluate the usefulness of a combination treatment of low-dose oral betamethasone and melanocyte-keratinocyte transplantation. METHODS: Oral betamethasone was given to patients who failed to respond either completely or partially to melanocyte-keratinocyte cell transplantation, and the procedure was repeated for previously treated and nontreated area. A simpler and modified method described by Mulekar was performed. RESULTS: Seventeen patients with vitiligo vulgaris and eight patients with segmental vitiligo were retransplanted after giving oral betamethasone for 2 to 10 months after the initial procedure. Two patients of vitiligo vulgaris and one of segmental vitiligo failed to respond completely even after repeat transplantation. Fifteen vulgaris and seven segmental patients showed excellent to good repigmentation after repeat transplantation. CONCLUSION: Combined treatment of oral betamethasone and melanocyte cell transplantation has a potential to produce complete repigmentation in patients with large vitiliginous areas.     

Modified Technique of Autologous Noncultured Epidermal Cell Transplantation for Repigmenting Vitiligo: A Pilot Study

BACKGROUND: Several reports have demonstrated that grafting of autologous melanocytes from normally pigmented donor skin can be used for repigmentation of achromic macules in vitiligo. OBJECTIVE: To investigate a modified approach in which noncultured autologous melanocytes and keratinocytes are grafted on superficially laser dermabraded vitiligo lesions in a suspension enriched with hyaluronic acid. METHODS: Four patients with stable vitiligo were treated using a noncultured melanocyte-keratinocyte suspension. The cellular suspension was grafted on vitiliginous lesions previously dermabraded with a CO2 laser. To improve the viscosity and fixation of the cellular suspension hyaluronic acid was added. Three weeks after grafting, psoralen plus ultraviolet A (PUVA) or ultraviolet B (UVB) therapy was started. Residual leukodermic areas were subsequently retreated. RESULTS: Repigmentation was observed within 2-4 weeks and continued to increase for 3 months after treatment. In all patients, 85-100% repigmentation was achieved. A temporary slight color mismatch was visible in all patients. The most homogeneous repigmentation was obtained 5 months after treatment. CONCLUSION: This modified procedure seems to be a simple and promising treatment for larger vitiliginous areas.     

Treatment of post-burn leucoderma with non-cultured melanocyte-keratinocyte transplantation (MKTP)

Introduction

Deep burns often result in hypo-pigmentation, referred to as leucoderma which has a similar psychosocial impact on the patients as that of vitiligo. Several tissue grafting methods have been reported to treat post-burn leucoderma.

Methods

A simple method consisting of harvesting a donor skin sample, preparation of an epidermal cell suspension and the transplantation of the cell suspension on to a dermabraded recipient area, was performed in a clean procedure room. No special laboratory set-up was used for the cell separation procedure. Patients were treated with 18 sessions of excimer laser starting 1 month post-operatively, to hasten the repigmentation.

Observation

Of the 10 patients treated with MKTP, 3 were lost to follow-up. The remaining 7 patients showed repigmentation ranging from 90% to 100% with good color matching.

Conclusion

MKTP is an effective method to treat post-burn leucoderma. No special precautions are required to treat any anatomical site or uneven scarred surface.