Dermoscopic assessment of treatment response in patients undergoing autologous non cultured epidermal cell suspension for the treatment of stable vitiligo: a prospective study.

BACKGROUND: There is lack of literature on serial dermatoscopic assessment in patients undergoing non-cultured epidermal cell suspension (NCES) for treatment of stable vitiligo.

OBJECTIVE: To evaluated the role of serial dermatoscopy in assessing disease stability and predicting repigmentation rates in vitiligo patients undergoing NCES MATERIAL AND METHODS: In this prospective study, dermatoscopic assessment of target lesions were done at baseline and post NCES at week 4, 8, 12, 16 and 24. Patches obtaining >90% repigmentation at 24 weeks were categorised to have obtained excellent repigmentation. The dermatoscopic features of target lesions that showed clinical signs of disease activity anytime during the follow-up period were compared to those maintaining clinical stability throughout.

RESULTS: Twenty-six vitiligo patients with 52 patches, clinically stable for atleast 1 year were recruited. At follow-up, six patches showed clinical signs of instability. Five patches in the unstable group developed satellite lesions by week 16, compared to none in the stable group (p <0.05). Excellent repigmentation was achieved in 29 out of 52 patches. Appearance of normal reticular pigment network at 8 weeks was a positive predictor of excellent response (OR=10.5, CI 1.2-89.7), whereas, altered pigment network at 12, 16 and 24 weeks and telangiectasias at 12 and 16 weeks significantly reduced the odds of excellent repigmentation.

CONCLUSION: Serial assessment of the vitiligo patches post NCES can help in early recognition of unstable patches. Appearance of normal pigment network at 8 weeks by dermatoscopy is a predictor of excellent repigmentation.