Background: Vitiligo is a common autoimmune inflammatory skin disease, where there are different\nsurgical techniques for treatment of stable patches of vitiligo. Objective: To find non-costly,\nminimally invasive, simple technique by direct melanocytes transplant by spade needle technique\nin treatment of vitiligo. Patients and Methods: This interventional, therapeutic, comparative study\nwas done in Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq from April\n2014-March 2015. Twenty patients with localized, generalized and segmental vitiligo were included.\nFull history and examination for each patient was done with 4 (20%) males and 16 (80%)\nfemales and their ages ranged from 9 - 40 (23.15 �± 11.44) years. Forty one patches in 20 patients\ntreated by spade grafting technique and the donor and recipient sites were demarcated and anesthesia\ndone by xylocaine 2% with adrenalin 1:100,000. Transplantation was started by using disposable\nneedle gauge 18 (the sharp end of needle was cut by a scissor to make it a spade like) with\nmedical syringe 5 ml supplied with normal saline. The micro-pieces were taken from donor site\nand transplanted directly, easily and rapidly into dermis of recipient site and followed by pushing\nnormal saline and the procedure was repeated to cover all recipient sites with 5 mm distance between\ninjection points. The surface area of the lesions was calculated and the reduction rate was\nestimated every month till the end of the 4th month period of the treatment. Results: Including 41\npatches in 20 patients with the surface area of the patches ranged from 1.5 - 90 cm2 (13.78 �±17.57) cm2. The mean �±SD of surface area of lesions was decreased from 13.78 �± 17.57 cm2 at\nbaseline visit to 13.61 �± 17.48 cm2 at the second visit (after 2 weeks ) which was statistically significant\n(p value 0.001). The mean surface area continued to be reduced till reaching 12.20 �±\n15.68 cm2 at the third visit and 12.01 �± 15.55 cm2 at the fourth visit. All were statistically significant\nwhen compared to baseline visit. There was reduction in surface area 1.1% at two weeks,\n9.93%, and 12.5% at the 2nd, 4th months respectively. Conclusions: Intradermal injection of melanocytes\nin patients with vitiligo by spade like needle was very quick and simple non-costly technique,\nand gave 12.5% reduction which could be repeated at different times until satisfactory\nre-pigmentation of vitiligenous skin is achieved.
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