Repigmentation of leucotrichia in vitiligo with noncultured cellular grafting

Summary Background  Vitiligo in hair-bearing areas is often associated with leucotrichia. Repigmentation of leucotrichia has been reported mainly with tissue and follicular hair grafts. Objectives  To evaluate the repigmentation response of leucotrichia after noncultured cellular grafting. Methods  We retrospectively reviewed patients with stable generalized and segmental vitiligo who underwent noncultured cellular grafting from March 2008 to November 2010 in areas with leucotrichia. The percentage repigmentation of white hairs was based on clinical assessment and standardized digital photography, and was graded ‘poor’, ‘fair’, ‘good’ or ‘excellent’, corresponding to a scale of 0–100% repigmentation with respective intervals of 25%. Results  Eighty-four patients with vitiligo underwent cellular grafting; of these, 13 had grafting in areas with leucotrichia. Twelve patients (92%) had poor repigmentation of leucotrichia 3 months after transplant. One patient defaulted follow-up after this period. At 6 months, fair repigmentation was achieved in eight out of the 12 remaining patients (67%). After 9–12 months, however, 91% (10 out of 11) of the patients achieved good or excellent repigmentation. One patient did not reach the 9-month follow-up period at the time of data analysis. Leucotrichia of eyebrows yielded excellent repigmentation in eight out of nine patients, whereas hairs on the limbs and scalp showed good repigmentation in two out of two patients at 9–12 months. Conclusions  Good to excellent repigmentation of leucotrichia can be achieved with noncultured cellular grafting, obviating the need for hair transplantation.