The minigrafting test for vitiligo: detection of stable lesions for melanocyte transplantation.

Abstract

Selected patients with stable and refractory vitiligo may consider melanocyte transplantation as a therapeutic alternative. A method to anticipate the response to surgical repair is not available. We evaluated the pigment spread of minigrafts when implanted within achromic lesions of stable vitiligo as a test to identify good candidates for surgical repigmentation. Four to six minigrafts of 1.0 to 1.2 mm were implanted within lesions of patients with unilateral (localized) and bilateral (generalized) vitiligo. Pigment spread was assessed 3 months later. Forty-seven subjects were examined. In unilateral vitiligo 19 of 20 patients (95%) had a positive test result in comparison with only 13 of 27 patients (48%) with bilateral vitiligo (p = 0.002). The minigrafting test is a reliable tool to identify patients with stable vitiligo who may respond to melanocyte transplantation. Unilateral (localized) vitiligo is the best indication for surgical repigmentation.