Vitiligo is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin are destroyed. As a result, white patches appear on the skin in different parts of the body. Similar patches also appear on both the mucous membranes (tissues that line the inside of the mouth and nose) and the retina (inner layer of the eyeball).
The hair that grows on areas affected by vitiligo sometimes turns white.
The cause of vitiligo is not known, but doctors and researchers have several different theories. There is strong evidence that people with vitiligo inherit a group of three genes that make them susceptible to depigmentation. The most widely accepted view is that the depigmentation occurs because vitiligo is an autoimmune disease – a disease in which a person’s immune system reacts against the body’s own organs or tissues. People’s bodies produce proteins called cytokines that, in vitiligo, alter their pigment-producing cells and cause these cells to die. Another theory is that melanocytes destroy themselves. Finally, some people have reported that a single event such as sunburn or emotional distress triggered vitiligo; however, these events have not been scientifically proven as causes of vitiligo.
Suction blister epidermal grafting is an established technique for the treatment of resistant and stable vitiligo especially over small and cosmetically important areas like the face. However, certain areas, such as lips and eyelids, require special considerations because of their anatomic peculiarities.
Punch grafting is a popular surgical technique for vitiligo treatment. Tiny bits (1,5mm diameter) of full-thickness skin is removed from a donor area such as the thighs, using a device called a biopsy punch. At the same time, equal sizes of holes are made in the recipient area (the white patch of vitiligo being treated), about 0,5cm apart. The punched out pieces of skin from the donor area are then transplanted into the recipient area. About 30 grafts can be easily inserted at one sitting. The process may be repeated to treat larger areas.
Results of punch grafting within three months of grafting. The pigment is steadily increasing to cover all the white areas.