高频电刀在表皮移植治疗不平整部位白癜风的临床应用

目的：观察高频电刀在表皮移植治疗不平整部位白癜风的疗效。方法：采用负压吸疱和高频电刀相结合进行自体表皮移植。结果：治疗37例白癜风患，共植入皮片267区，其中治愈201区(75.28％)，显效39区(14．61％)，有效10区(3．74％)，无效17区(6．38％)，总有效率93．63％。结论：采用高频电刀去除受皮区表皮的方法更适合于非平整部位白癜风表皮移植，且简单易掌握，疗效好。     

计算机图像分析对自体表皮移植治疗白癜风的疗效评定

应用计算机数字图像分析系统测定6例白癜风患者自体表皮移植前后的面积和平均灰度。结果皮损面积平均消失56．93％，皮损区治疗前后的平均灰度相差明显（平均值分别为130．67和114．83），治疗后的效果与皮损相邻近正常皮肤的平均灰度（平均值为114．17）接近。     

自体表皮移植治疗白癜风疗效观察及体会

自体表皮移植治疗白癜风疗效观察及体会王琪，陈孟禄中国民航北京医院皮肤科（邮政编码１０００２５）我们于１９８９～１９９０年用自体表皮移植法治疗４例白癜风病人，现报告如下。临床资料见表１。方法１．器具：负压吸引器１台．自制玻璃吸杯数个。２．吸疱：皮损区先...     

应用刮除法处理眼睑部白癜风皮损进行白体表皮移植治疗的临床研究

目的研究和观察应用括除术处理眼睑部白癜风皮损进行自体表皮移植治疗的临床疗效与安全性。方法选择眼睑部和额、颊部的稳定期白癜风患者,分别应用括除术法和磨削法处理受皮区,常规进行负压加温吸疱自体表皮移植治疗,移植后对比分析临床疗效和安全性。结果11例眼睑部和10例面颊部、额部白癜风皮损,分别移植疱壁53、48片,移植后2组总成活率分别为94．34％、95．83％;2组3级以上的复色率分别为86．79％,89．58％,2组差异无统计学意义（P〉0．05）。移植过程和移植后均无不良反应。结论应用括除术处理受皮区进行自体表皮移植治疗眼睑部白癜风,具有临床疗效好与安全性可靠的优势,值得临床上推广和应用。     

口服中药联合自体表皮移植治疗白癜风疗效观察

目的：中药对自体表皮移植治疗白癜风的治疗作用。方法：以口服中药联合自体表皮移植与单纯自体表皮移植治疗白癜风的疗效进行比较。结果：中药联合自体表皮移植与单纯自体表皮移植组（对照组）治疗白癜风的疗效比较差异有显著性意义（P＜0．05）,结论：提示中药能迅速控制病情,使白癜风进展期转为稳定期,提高自体表皮移植治疗白癜风的成功率。     

自体表皮移植治疗白癜风疗效评价及相关因素分析

目的 评估自体表皮移植治疗白癜风的长期疗效及其相关影响因素。方法 通过问卷调查、电话随访、临床复诊的方式，观察负压吸疱自体表皮移植治疗白癜风的长期疗效，并分析其与移植后时间的长短、是否联合照射窄波UVB、以及与患者性别、年龄、治疗部位和是否伴发供皮区同形反应的相关性。 结果 接受自体表皮移植资料完整的白癜风患者310例，病期稳定至少半年以上，男161例，女149例，平均年龄（26.69 ± 11.76）岁。局限型98例，节段型123例，散在型62例，泛发型27例。共移植皮片1266片，随访1 ~ 5年后发现，痊愈815片，显效167片，好转117片，无效167片，治愈率64.38％，总有效率86.81％。另外，发现移植处色素沉着过度76例，占24.52％；色素减退66例，占21.29％，供皮区色素沉着过度34例，占10.97％，移植部位复发30例，占9.677％；其他部位新发12例，占3.871％，供皮区发生同形反应25例，占8.064%。对可能影响疗效的相关因素分析显示，自体表皮移植治疗白癜风后2年内尚稳定，随着时间的延长，疗效稍降低；活动较少、容易固定的部位疗效较好，其中腿部和手臂的效果最好，手足部、胸背部、面颈部次之，腰腹部效果最差（P < 0.01）。术后窄波UVB照射可以促进皮肤色素生成，供皮区发生同形反应对移植后疗效有一定影响（P < 0.05），移植疗效与性别及年龄无关（P > 0.05）。结论 自体表皮移植治疗白癜风的长期疗效较好，移植部位是影响疗效的主要因素。     

超脉冲CO2激光结合自体表皮移植治疗白癜风

目的 探讨CO2激光结合自体表皮移植治疗白癜风的临床疗效。方法 对1605例白癜风患者进行自体表皮移植治疗，共植皮30660片，其中局限型782例12151片，节段型319例8221片，泛发型226例7376片，散发型278例2912片。采用发疱取皮法，受皮区采用CO2激光汽化创面形成，治疗8周后判断疗效。结果 治愈率79．04％，有效率13．17％，总有效率92．21％。以局限型和散发型效果最好，泛发型效果较差，身体各部以面部效果最佳，胸背部次之，眉区及发际最差。结论 超脉冲CO2激光辅助自体表皮移植治疗白癜风具有操作简单、方便，手术时间短，出血少，皮片易存活，治愈率高的优点，值得临床推广。     

用五种方法治疗白癜风临床疗效观察（附186例报告）

目的本文随机将186例（男126例，女60例）各型（局限型85例，节段型28例，泛发型15例，黏膜型2例，混合型56例）白癜风患者分为5组，进行对比研究观察其疗效，寻求最佳治疗方法。方法将其分为：外用药物治疗组51例，外用药物联合免疫调节剂治疗组88例，表皮移植组22例，表皮细胞混悬液移植组17例，外用药物联合免疫调节剂及大剂量激素冲击治疗组8例。各组病例统一疗效判断及标准，并进行统计学处理，进行显著性比较。结果提示各种治疗均有效。外用药物治疗组有效率（治愈＋显效＋有效）88．2％，外用药物联合调节剂治疗组有效率90．9％，表皮移植有效率100％，细胞混悬液移植组有效率100％，外用药物联合免疫及大剂量激素冲击治疗组有效率100％。统计学处理提示各治疗组之间有效率差异无显著性，但显效率（治愈＋显效）之间差异有显著性。外用药物治疗组显效率15．7％，外用药物联合免疫调节剂治疗组显效率26．0％，前者明显低于后者。证明表皮移植、细胞混悬液移植、外用药物联合免疫调节剂大剂量激素冲击治疗为目前治疗白癜风最佳方法之一，如能联合使用，疗效确切，是对于外用药物及外用药物联合免疫调节剂的一个补充。结论白癜风的治疗目前仍是一个棘手的问题。上述所介绍的方法无疑是在实践中切实可行的方法，各有特色，可以酌情选择，也可以联合应用，相互补充。     

自体表皮移植术治疗白癜风52例疗效分析

目的：观察白癜风自体表皮移植治疗术的疗效，探讨其成功的关键环节及失败的常见原因。方法：选取符合手术指征的白癜风患者52例，行自体表皮移植治疗术，于手术3个月后随访观察疗效。结果：52例白癜风患者治愈率82．69％，显效率100％，患者满意率100％。结论：采用自体表皮移植术治疗稳定期白癜风，手术安全，病人痛苦少，术后见效快，值得在临床上推广。     

自体表皮移植治疗色素脱失性皮肤病的追踪观察

本文对自体表皮移植治疗的46例色素脱失性皮肤病病人(其中白癜风40例、晕痣5例、斑驳病1例)，通过问卷及临床复诊进行追踪观察。了解自体表皮移植术治疗色素脱失性皮肤病的远期疗效。结果：46例中显效78．97％，有效14．56％，无效6．47％。经2．8年随访，31例局限型及7例节段型白癜风患者未见复发。自体表皮移植术是治疗稳定期局限型及节段型白癜风的首选方法。     

泼尼松龙联合自体表皮移植治疗白癜风的临床疗效观察

目的：探讨泼尼松龙联合自体表皮移植治疗白癜风的临床疗效。方法：采用门诊病历统计法,将患者分3组：A组55例（为试验组）泼尼松龙皮损内注射加皮肤磨削后,自体表皮移植联合治疗。B组80例,用泼尼松龙皮损内注射加白灵内服和外擦治疗,C组65例,用白灵内,外用药加皮肤磨削术治疗。结果：3组疗效比较,以A组疗效最好,结论：先用泼尼松龙皮损内注射,稳定病情发展,再进行皮肤磨削加自体表皮移植术,疗效肯定,又无任何不良反应。     

自体表皮移植术加磨削术治疗白癜风的疗效观察

目的:探讨表皮移植术加磨削术对白癜风的疗效。方法:对126例白癜风患者采用自体表皮移植术加磨削术,其中局限型80例,节段型41例,泛发型5例,共移植白斑区386个,每皮瓣植入直径0.8cm～1cm,共植入皮瓣4632处。结果:皮瓣成活率95.12％,其中治愈119例,显效3例,有效2例,无效2例,总有效率98.41％。所有患者观察随访半年以上,移植后10天左右色素形成,1个月左右色素基本恢复正常,3个月左右色素完全恢复。结论:该法效果好、副作用少。     

A prospective,randomized clinical study to compare the efficacy of recipient site preparation using dermabrasion,cryoblister, and dermaroller in autologous noncultured epidermal cell suspension in stable vitiligo

Noncultured epidermal cell suspension (NCES) is a well‐established surgical treatment modality for stable vitiligo. The outcome of this procedure significantly depends on the method of recipient site preparation, a critical step to achieve cosmetically acceptable repigmentation. To compare the efficacy of recipient site preparation using three methods namely, dermabrasion, cryoblister, and dermaroller followed by NCES in stable vitiligo. In this single‐center, prospective, intra‐patient, randomized clinical trial; 36 participants having at least three vitiligo patches in same anatomic region with minimum lesional stability of 1 year were randomized 1:1:1 for recipient site preparation using manual dermabrasion, cryoblister, and dermaroller followed by NCES. Patients were followed up at 4, 8, and 12 weeks and assessment of extent and pattern of repigmentation, color match and patient satisfaction were done. Among 36 patients, 22 (61.1%) were females; mean (SD) age was 28.33 (9.4) years. Dermabrasion and cryoblister techniques showed equal efficacy with respect to extent of repigmentation (>75% repigmentation; 55.6% vs 47.2%; P = .63) and patient satisfaction score (20.2 ± 9.6 vs 19.9 ± 7.9, P = .194). However, dermabrasion was superior to cryoblister in terms of rapidity (65% vs 32.5% at 4 weeks, P = .04) and color match (47.2% vs 19.4%, P = .004). Dermaroller had poor repigmentation outcomes compared to both dermabrasion and cryoblister. Cryoblister as a method of recipient site preparation is equally effective as manual dermabrasion in NCES for attaining good to excellent repigmentation, but with risk of hyperpigmentation. However, dermaroller is inferior to both dermabrasion and cryoblister.     

加压负压吸疱与磨削自体表皮移植治疗白癜风

目的：缩短白癜风自体表皮移植起疱时间和减少手术次数。方法：用加压负压吸疱结合磨削术对30例白癜风患者行自体表皮移植，并加压负压吸疱与单纯负压中疱的发疱时间进行比较。结果：加压负压吸疱移植皮片的痊愈率为72．2％，显效率14．9％，总有效率96．1％，与单纯负压吸疱相比，起疱时间有显著性差异，前者快于后者，结论：加压负压吸疱结合磨削术是一快速，安全，有效的方法，优于单纯的负压吸疱。     

Comparative evaluation of the therapeutic efficacy of dermabrasion, dermabrasion combined with topical 5% 5-fluorouracil cream, and dermabrasion combined with topical placentrex gel in localized stable vitiligo

BACKGROUND: Vitiligo affects 1% of the world's population with a higher incidence in dark-skinned individuals. Many medical treatments have been attempted with partial success, but recent focus has been on surgical techniques. The aim of this study was to evaluate and compare the therapeutic efficacy of dermabrasion, dermabrasion combined with 5% 5-fluorouracil cream, and dermabrasion combined with topical placentrex gel in the management of localized stable vitiligo. METHODS: Thirty patients with localized stable vitiligo (at least three lesions each) were treated. After dermabrasion, a soframycin tulle dressing was placed on the first lesion, a topical 5% 5-fluorouracil dressing on the second, and a topical placentrex gel dressing on the third for 7 days after the procedure, and the patients were followed up for 6 months. RESULTS: The efficacy of treatment was highest (73.33%) and most rapid in lesions treated with dermabrasion combined with 5-fluorouracil. Dermabrasion alone and dermabrasion combined with placentrex gel showed similar efficacy in localized stable vitiligo. CONCLUSION: Dermabrasion combined with 5-fluorouracil is the most efficacious of the three treatment modalities studied.     

Effect of a preceding laser dermabrasion on the outcome of combined therapy with narrowband ultraviolet B and potent topical steroids for treating nonsegmental vitiligo in resistant localizations

Background  The treatment of vitiligo remains unsatisfactory. Objectives To assess in patients with vitiligo the effect of a laser dermabrasion in addition to the association of topical steroids and ultraviolet (UV) B in difficult‐to‐treat areas. Methods This was a single‐centre prospective randomized trial including patients with nonsegmental vitiligo who had at least two symmetrical lesions located on bony prominences and/or extremities. An erbium laser‐assisted dermabrasion was first performed on one side (randomly assigned). After 48 h, hydrocortisone 17‐butyrate cream applied daily for three periods of 3 weeks followed by a 1‐week steroid‐free interval and narrowband UVB treatment was performed on both sides twice weekly for 12 weeks. The evaluation was performed on standardized pictures by two physicians blinded to the type of treatment received. The criterion of success was a repigmentation of at least 50%, 1 month after the end of the treatment. Results Eighteen patients were included (24 paired lesions treated). Two patients dropped out for personal reasons. Almost 50% of lesions achieved at least 50% repigmentation in the dermabrasion side while only 4·2% did so with topical steroids and UVB alone (P < 10^?4). Side‐effects were delayed healing, pain and two hypertrophic scars. The tolerance and patient satisfaction were 4·2 and 4/10 for the laser‐treated side and 8·4 and 3/10 in the UVB+ steroids alone group, respectively. Conclusions Laser dermabrasion significantly improves the repigmentation rate in vitiligo lesions. Despite a high rate of repigmentation in such difficult‐to‐treat areas the high rate of side‐effects and the poor tolerance strongly limit its use in current practice.     

Naevus anaemicus with teleangiectatic vessels.

We describe a 20-year-old man with naevus anaemicus on the chest where, after dermabrasion of the epidermis, enlarged teleangiectatic dark-red vessels were seen within the previously pale area. They were clearly different from those seen on dermabrasion at this site in normal skin and in patients with vitiligo where the area is lighter red with only small punctual bleedings from arterial capillaries. The naevus anaemicus and a port-wine stain (naevus flammeus) in the same location is a phenomenon of vascular twin spotting, which was revealed when the epidermis was removed. The area was transplanted with thin epidermal grafts and healed within 2 weeks. One year later the naevus looked the same as before grafting. Much thicker grafts than those used by us will be needed, but they are not cosmetically acceptable.     

SilkTouch激光磨削后自体表皮移植治疗非平整部位白癜风疗效观察

目的：观察自体表皮移植结合SilkTouch激光磨削治疗非平整部位白癜风的疗效。方法：118例稳定期白癜风患者共有白斑245片,白斑分布于面部五官周围,颈部,腕、肘关节以及手、足等非平整部位。每例患者先在其面积最大的1片皮损中随机选取4个象限中1个象限的部分皮损,用凹凸型吸盘负压发疱法去除表皮作为对照。其余白斑部位均采用SilkTouch激光磨削法去除表皮,制备自体表皮移植的受区;供区则用负压发疱法制备表皮,然后将供区表皮移植于受区,并加压包扎7d。结果：全部患者均连续观察1年以上,激光磨削组245片皮损痊愈53片(21．6％),显效171片(69．8％),有效率91．4％．对照组118片皮损痊愈30片(25．4％),显效80片(67．8％),有效率93．2％,两组疗效统计学上差异无显著性,激光磨削组较对照组白斑处色素恢复均匀。结论：自体表皮移植结合SilkTouch激光磨削治疗白癜风不受部位限制．操作简便．术后疗效满意。