VITILIGO - SURGICAL REPIGMENTATION OF LEUKOTRICHIA

BACKGROUND. Patients With vitiligo frequently have premature gray hair . Until recently the literature was silent about its management. While surgically treating vitiligo, we incidentally observed repigmentation of gray hair. OBJECTIVE. Based on our observations we undertook this study to see the effect of surgical treatment of vitiligo on repigment ation of leukotrichia, as well as to evaluate the percentage of repigm entation, if any, in the different hair-bearing areas, and the time ta ken for it. METHODS. A case series of eight patients with nine patches of localized, stable, and refractory vitiligo with leukotrichia of 3- 12 years duration is presented. The patients were followed up for 2-6 years. One patient was lost from follow-up after 2 months. The vitilig o was treated by dermabrasion and thin split-thickness skin grafting u nder local anesthesia, as outpatients. RESULTS. Repigmentation of the hair occurred in all the areas but it was seen earlier (3 months) and was move complete in the eyebrows (70-95%). In the scalp and the beard areas it started later (6-9 months) and was around 50-60% only. The d egree of pigmentation increased until about 3 years after surgery. No complications in the form of graft loss or alopecia Were observed. CON CLUSIONS. Partial to near-total repigmentation of leukotrichia can be achieved surgically. Contrary to the present theory, we hypothesize th at melanocytes also migrate from the repigmented epidermis to the hair follicle, resulting in repigmentation of the hair.