Repigmentation of Leukotrichia by Epidermal Grafting and Systemic Psoralen Plus UV-A

To the Editor.—  Vitiligo is an acquired depigmenting condition of unknown cause in which melanocytes are damaged; when destroyed, achromic areas of varying size and location are formed. Leukotrichia is associated with a poor prognosis, probably because it indicates that the melanocyte reservoir within the hair bulb has been destroyed. In such cases, the possibility of repigmentation is minimal. Several procedures for treating depigmented glabrous skin have been reported to be effective, including grafts of suction-blistered epidermis,¹ Ollier-Thiersch's grafts,² or minigrafts.³ We describe three patients with vitiligo who showed repigmentation of leukotrichia on the eyebrow by undergoing epidermal grafting and receiving psoralen plus UV-A (PUVA).

Report of Cases.—  Three patients with vitiligo were treated by systemic PUVA without repigmentation for more than 6 months. Their clinical data are shown in the Table. We performed the epidermal grafting. The white hairs on the recipient eyebrow (Fig 1) were shaved. Blisters on the recipient site formed within 24 hours after three freeze-thaw cycles with liquid nitrogen. Blisters on the donor site were made by suction from the patient's inner arm. After approximately 1 hour of suction at 200 mm Hg, minute vesicles