The application of electrolysis of depigmented hair using a trichiasis electrolyzer combined with single hair follicle transplantation for the treatment of vitiligo-associated leukotrichia

Management of the refractory vitiligo patient: current therapeutic strategies and future options

Vitiligo is an autoimmune disease that leads to disfiguring depigmented lesions of skin and mucosa. Although effective treatments are available for vitiligo, there are still some patients with poor responses to conventional treatment. Refractory vitiligo lesions are mostly located on exposed sites such as acral sites and lips, leading to significant life stress. Understanding the causes of refractory vitiligo and developing targeted treatments are essential to enhance vitiligo outcomes. In this review, we summarized recent treatment approaches and some potential methods for refractory vitiligo. Janus kinase inhibitors have shown efficacy in refractory vitiligo. A variety of surgical interventions and fractional carbon dioxide laser have been widely applied to combination therapies. Furthermore, melanocyte regeneration and activation therapies are potentially effective strategies. Patients with refractory vitiligo should be referred to psychological monitoring and interventions to reduce the potential pathogenic effects of chronic stress. Finally, methods for depigmentation and camouflage may be beneficial in achieving uniform skin color and improved quality of life. Our ultimate focus is to provide alternative options for refractory vitiligo and to bring inspiration to future research.

Transversely Sectioned Mini-Punch Grafting: A Novel Technique for Effective Treatment of Hairline Vitiligo

Objective

Hairline vitiligo is a special area. Hairy areas within the hairline often require repigmentation and regrowing hair shafts. The face and forehead outside the hairline do not require regrowing hair shafts, only repigmentation. To tackle this issue, we modified the conventional mini-punch grafting with a combined application of mini-punch grafting and follicular hair transplant.

Methods

Five patients with localized hairline stable vitiligo aged 26-32 years old had a history of nonsurgical treatments for at least 3 months and without progress. The grafts were transversely sectioned. The intact half follicles were preserved below the cross-section. Sectioned grafts were placed into the chambers for transplanting with forceps.

Results

The treatment using transversely sectioned mini-punch grafting with the patient was performed for all five patients, and the results were satisfactory. In the area of the forehead outside the hairline with the sectioned mini-punch grafting above the cross-section, hair loss and repigmentation were observed. In the area of the hairy areas within the hairline, growing hair shafts and repigmentation were observed, without hair loss.

Conclusion

Our report can help to manage hairline vitiligo or hairy areas vitiligo. This method can be considered a potential method for the treatment of hairline vitiligo, thus providing a simple solution to complex problems.