Characterization of clinical response in patients with vitiligo undergoing autologous epidermal punch grafting

BACKGROUND: Punch grafting is a well-established treatment for vitiligo, but predictive factors for outcomes are not well established. OBJECTIVE: To determine the characteristics of responses to punch grafting performed in patients with vitiligo. METHODS AND MATERIALS: Retrospective, single-center chart review. Response rates were assessed using photographs taken before and after grafting using a 1.5-mm punch instrument. Effectiveness of repigmentation was assessed using the following scale: worse, no improvement, 0% to 25% improvement, 25% to 50% improvement, 50% to 75% improvement, and 75% to 100% improvement. Repigmentation rates were correlated with patient demographics. RESULTS: Thirty-seven charts were reviewed, from which data were available from 30 patients. The total number grafts was 606 in 44 transplanted areas; 87% (530/606) of the transplants survived, and 26 of the 30 (87%) patients achieved some degree of repigmentation. Patients younger than 20 achieved the greatest average improvement in repigmentation (mean 61%), whereas those aged 60 and older showed the least improvement (mean 38%). Punch grafting of the neck and trunk achieved the greatest repigmentation, with 65% and 63% average improvement, respectively. Acral sites and skin overlying joints improved the least. CONCLUSION: Punch grafting is successful in most patients with vitiligo, with an 87% graft survival rate, but the rates of repigmentation vary depending on clinical characteristics.