الفهرس 
Evaluation of autologous,non-cultured melanocyte- keratinocyte cell suspension and punch grafting in the treatment of acral and non-acral vitiligo lesions : A right-left comparitive study
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Abstract
Background: Acral vitiligo shows more resistance to conventional lines of treatment than non-acral vitiligo as well as to surgical interventions. Objective: To evaluate the response of acral vitiligo to treatment after supplying the missing reservoir and evaluate and compare the efficacy of autologous non- cultured melanocyte-keratinocyte cell suspension (NCMKS) and autologous punch grafting in the treatment of both acral and non-acral lesions of vitiligo. Methods: This prospective right-left comparison study was carried on 34 patients with non-segmental stable vitiligo with acral and non-acral, bilateral and symmetrical lesions. In each patient four areas were treated (acral and non-acral) with either NCMKS or punch grafting. In case of NCMKS, the recipient site was prepared by either manual dermabrasion, CO2 laser resurfacing, suction blister or cryoblebbing, while the donor area was obtained by either thiersch graft or suction blister.Conclusion: Although acral and non-acral lesions reacted similarly in around half of the cases, acral vitiligo lesions are more resistant to treatment even after administration of the reservoir. A defect in melanocyte environment in those areas is expected. NCMKS is better than punch grafting for acral skin especially when prepared by CO2 laser resurfacing