Introduction: Replenishing melanocytes selectively in vitiliginous macules by autologous noncultured epidermal cell suspension (NECS) is a promising approach. Limitation of this surgery is its expensive reagents. Platelet-poor (PPP) plasma may replace these expensive reagents. Objective: To evaluate the surgical results when two reagents, namely trypsin inhibitor and Dulbecco's modified Eagle's medium (DMEM), are replaced by patient's PPP as media in NECS. Materials and methods: Descriptive and inferential statistical analysis has been carried out in a clinical study that enrolled 60 stable vitiligo lesions from 60 patients who formed the study group. Patients received melanocytes suspended in their own PPP. Results: Results show that 96.7% repigmentation was achieved in 29 of 30 lesions. Additionally, 3.3% lesions achieved poor repigmentation. Statistical analysis revealed no significant differences with respect to the repigmentation achieved or adverse effects observed. Discussion: Trypsin inhibitor can be replaced by blood plasma as plasma contains alpha 1 antitrypsin, which covalently binds and inactivates action of trypsin. Effective results with blood plasma was possibly due to growth factors in serum which may enhance activity of melanocytes. It also enhances the viscosity of suspension. Conclusion: Platelet-poor plasma can be one of the novel surgical modalities. It is cost-effective and beneficial for our vitiligo patients.
Anstey AV. Disorders of skin. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's textbook of dermatology. 8th ed. UK: Wiley-Blackwell; 2010. pp. 46-49.
Shah H, Mehta A, Astik B. Clinical and sociodemographic study of vitiligo. Indian J Dermatol Venereol Leprol 2008 Nov-Dec;74(6):701.
Hassan I, Mubashir S, Abdullah Z, Sajad P, Anwar P, Sheikh G, Sami A, Yaseen A. Autologous non cultured epidermal cell suspension in case of resistant segmental vitiligo: a preliminary study. J Pak Acad Dermatol 2013;23(2): 190-193.
Munish P. Autologous non-cultured basal cell-enriched epidermal cell suspension transplantation in vitiligo: Indian experience. J Cutan Aesthet Surg 2011 Jan-Apr;4(1): 23-28.
Sahni K, Prasad D, Kanwar AJ, Mehta SD. Autologous noncultured melanocyte transplantation for stable vitiligo: can suspending autologous melanocytes in the patients’ own serum improve repigmentation and patient satisfaction? Dermatol Surg. 2011 Feb;37(2):176-182.
Majid I. Grafting in vitiligo: how to get better results and how to avoid complications. J Cutan Aesthet Surg Apr-Jun 2013;6(2):83-89.
Shirley F, Canni MC, Laskowski. Determination of trypsin inhibitor in blood plasma. J Biol Chem. 1953;19:147.
Gupta S, Narang T, Olsson MJ, Ortonne JP. Surgical management of vitiligo and other leukodermas: evidence-based practice guidelines. In: Gupta S, Olsson MJ, Kanwar AJ, Ortonne JP, editors. Surgical management of vitiligo. 1st ed. Massachusetts: Blackwell Publishing; 2007. pp. 69-79.
Gauthier Y, Surleve-Bazeille JE. Autologous grafting with non cultured melanocytes: a simplified method for treatment study of depigmented lesions. J Am Acad Dermatol 1992 Feb;26(2):191-194.
Van Geel NV, Ongenae K, Mil MD, Naeyaert JM. Double blind placebo-controlled study of autologous transplanted epidermal cell suspension for repigmenting vitiligo. Arch Dermatol 2004 Oct;140(10):1203-1208.
Sobhy N, Atia A, Elramly M. Some modifications in transplantation of autologous non-cultured melanocyteskeratinocytes suspension in treatment of segmental and focal vitiligo (Egyptian experience in Alexandria university). Our Dermatol Online 2013;4(1):5-10.
Huggins RH, Henderson MD, Mulekar SV, Ozog DM, Kerr HA, Jabobsen G, Lim HW, Hamzavi IH. Melanocytekeratinocyte transplantation procedure in the treatment of vitiligo: the experience of an academic medical center in the United States. J Am Acad Dermatol 2012 May;66(5):785-793.
Gauthier Y, Benzekri L. Non-cultured epidermal suspension in vitiligo: from laboratory to clinic. Indian J Dermatol Venereol Leprol 2012 Jan-Feb;78(1):59-63.
Sobhy N, Elbeheiry A, ELramly M, Saber H, Kamel L, Soror O. Transplantation of non cultured melanocytes vs dermabration and split thickness grafting in cases of non progressive vitiligo and stable forms of leucoderma [MD thesis]. Alexandria Dermatology Department; 2002.
Olsson M, Juhlin L. long-term follow-up of leukoderma patients treated with transplants of autologous cultured melanocytes, ultrathin epidermal sheets and basal cell layer suspension. Br J Dermatol 2002;47:893-904.
Hall JE. Chapter 25: Body fluid compartments, extracellular and intracellular fluids. In: Hall JE, editor. Guyton and hall textbook of medical physiology. 13th ed. Philadelphia (PA): Elsevier; 2015. p. 287.
Arshdeep, Kumaran MS. Platelet-rich plasma in dermatology: boon or a bane? Indian J Dermatol Venereol Leprol 2014 Jan-Feb;80(1):5-14.
Szabad G, Kormos B, Pivarcsi A, Széll M, Kis K, Kenderessy Szabó A, Dobozy A, Kemény L, Bata-Csörgo Z. Human adult epidermal melanocytes cultured without chemical mitogens express the EGF receptor and respond to EGF. Arch Dermatol Res 2007 Jul;299(4):191-200.
Pandya V, Parmar KS, Shah BJ, Bilimoria FE. A study of autologous melanocyte transfer in treatment of stable vitiligo. Indian J Dermatol Venereol Leprol 2005 Nov-Dec;71(6):393-397.
Austin LM, Boissy RE, Jacobson BS, Smyth JR Jr. The detection of melanocyte autoantibodies in the Smyth chicken model for vitiligo. Clin Immunol Immunopathol 1992 Aug;64(2): 112-120.
Searle EA, Austin LM, Boissy YL, Zhao H, Nordlund JJ, Boissy RE. Smyth chicken melanocyte autoantibodies: crossspecies recognition, in vivo binding, and plasma membrane reactivity of the antiserum. Pigment Cell Res 1993 Jun;6(3): 145-157.