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흡입수포를 이용한 비배양표피세포이식술로 치료한 난치성 백반증 1예
은성혜 ( Sung Hye Eun ),정유석 ( Yu Seok Jung ),이한나 ( Hanna Lee ),이지혜 ( Ji Hae Lee ),김경문 ( Gyong Moon Kim ),배정민 ( Jung Min Bae ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.9
Vitiligo is a commonly acquired cutaneous depigmentation disorder that affects 0.5∼1% of the population worldwide. While phototherapy is the primary treatment for vitiligo, surgical methods can be used for treating patients who are refractory to conventional treatments. Herein, we present the case of a 14-year-old Korean girl who developed vitiligo after hematopoietic stem cell transplantation for the treatment of acute lymphoblastic leukemia. She had multiple depigmented patches on her lower legs that did not respond to narrow-band ultraviolet B phototherapy for 7 months. The depigmented patches were successfully treated by transplantation of non-cultured epidermal cell suspension from the epidermal roof of the suction blister in the right inner thigh. No adverse event, such as secondary infection or scarring in both the donor and recipient sites, was noted. We recommended that non-cultured epidermal cell suspension transplantation using the suction blister method would be a safe and effective option for the treatment of refractory vitiligo. (Korean J Dermatol 2018;56(9):552∼555)
은성혜 ( Sung Hye Eun ),이한나 ( Han Na Lee ),김수형 ( Soo Hyung Kim ),이로우 ( Ro Woo Lee ),주현정 ( Hyun Jeong Ju ),이지혜 ( Ji Hae Lee ),김경문 ( Gyong Moon Kim ),배정민 ( Jung Min Bae ) 대한피부과학회 2020 대한피부과학회지 Vol.58 No.1
Background: Micropigmentation is a medical tattooing procedure in which pigments are implanted into the superficial dermis using a manual or electrically driven needle. Objective: We aimed to assess the benefit and risk of micropigmentation in the treatment of acral vitiligo refractory to the conventional treatment. Methods: An open-label study was conducted from December 2018 to March 2019. A total of 12 patients with 20 acral vitiligo lesions were treated with micropigmentation using an electric tattooing machine. The micropigmentation treatment was repeated for a few sessions to achieve optimal pigmentation. Color matching between the lesion and peri-lesional skin was assessed using a 4-point grading scale (poor, fair, good, and excellent). Results: Overall, 85% (17 of 20) showed excellent color matching after a median of 2 (range: 1∼5) treatment sessions. The post-treatment color was darker than the surrounding skin immediately after the procedure, but it gradually faded over time. Pain during the procedure was not mild, but local anesthetic injection was not required. Post-treatment erythema and swelling occurred, but they resolved within a few days. No allergic reaction to the pigment or koebnerization of the vitiligo was noted. Conclusion: Micropigmentation could be a promising treatment option for refractory acral vitiligo. A few treatment sessions (i.e., retouch) may be required for desired outcomes. The crucial parts of micropigmentation are pigment selection and implantation depth. It does not require injection of local anesthetics and provides immediate treatment effects after the procedure. (Korean J Dermatol 2020;58(1):20∼25)
난치성 백반증에 대한 흡입물집을 이용한 비배양 표피세포이식술 20례
배정민 ( Jung Min Bae ),정한미 ( Han Mi Jung ),이한나 ( Han Na Lee ),이로우 ( Ro Woo Lee ),은성혜 ( Sung Hye Eun ),권혁선 ( Hyuck Sun Kwon ),이지혜 ( Ji Hae Lee ),김경문 ( Gyong Moon Kim ) 대한피부과학회 2018 대한피부과학회지 Vol.56 No.7
Background: As nonsurgical interventions for vitiligo are not always successful, various surgical modalities have been used in patients with refractory vitiligo. Of these, non-cultured epidermal suspension transplantation (NCES) was recently introduced to treat large recipient sites using cells from small donor tissue. Objective: We assessed the effectiveness and safety of NCES as a surgical treatment for patients with refractory vitiligo. Methods: We retrospectively reviewed 20 cases in 17 patients (11 females; median age 25 years) who underwent NCES from July 2015 through March 2018. Suction blisters (20 mm in diameter) were collected from the patient’s inner thigh at a donor-to-recipient area ratio of 1:5. After the addition of 5 mL recombinant trypsin solution to the suction blisters, followed by incubation at 37°C for 60 min, epidermal cells were manually scraped off the blister surface, and epidermal cell suspension was obtained by centrifugation at 1,500 RPM for 5 min. The suspension was applied to the vitiligo regions after epidermal ablation of those regions. Phototherapy resumed 1 month later. Treatment success was defined as ≥75% repigmentation of the surgical site, and all adverse events were noted. Results: Overall, 85.0% of cases (17/20) exhibited treatment success. Adverse events included hyperpigmentation (20%) and surgical site infection (5%), but the treatment was tolerable in all cases. Conclusion: NCES is a reliable surgical option for patients with vitiligo refractory to nonsurgical treatment. Large areas of vitiligo can be treated by NCES, and use of this technique should be encouraged in Korea. (Korean J Dermatol 2018;56(7):426∼432)