穩定型分節型與非分節型白斑症患者的表皮色素移植療效和安全性

摘 要：

白斑症是一種常見且對心理造成嚴重影響的色素障礙疾病。當藥物治療無效時，外科移植常用於治療穩定型白斑症。自動表皮微移植採集（AEMH）系統最初設計用於治療創傷，但僅有少數研究探討了AEMH在白斑症中的應用。本研究旨在調查AEMH系統在穩定型節段性和非節段性白斑症患者中的療效和安全性。我們每兩個月記錄一次再色素沉著率和不良事件，持續至少12個月。根據患者特徵、白斑症亞型和不同解剖位置分析療效。研究共納入34名患者的56個色素脫失病灶。95.50%的自動表皮微移植物成功移植到受體部位。接受AEMH治療的患者在白斑症面積評分指數（VASI）和皮膚病生活質量指數（DLQI）上有顯著改善（p < 0.001）。VASI評分顯示，再色素沉著率從治療前的96.25 ± 8.59提高到治療後的48.30 ± 28.16（p < 0.001）。節段性和穩定型非節段性白斑症患者之間的治療效果相當。面部和頸部區域效果最好，其次是軀幹（胸部、腹部、背部和腋窩），四肢區域次之，而末端區域效果最差（p < 0.014）。總的來說，AEMH在穩定型白斑症患者中是一種有效且不良事件有限的治療方法。這種採集方法可能成為白斑症手術治療的可行選擇。

Vitiligo is a common, psychologically devastating pigmentary disorder. Surgical graftings are used to treat stable vitiligo when medical treatment fails. An automated epidermal micrograft harvesting (AEMH) system was first designated to treat wounds, and very few studies investigated the application of AEMH in vitiligo. In this study, we investigated the efficacy and safety of the AEMH system in patients with stable segmental and nonsegmental vitiligo. The rate of repigmentation and adverse events was recorded bimonthly for at least 12 months. We analyzed the efficacy based on patient characteristics, vitiligo subtypes, and different anatomical locations. A total of 56 depigmented lesions from 34 patients were included. 95.50% of the automated epidermal micrografts were successfully grafted at the recipient sites. There was a significant improvement in Vitiligo Area Scoring Index (VASI) and Dermatologic Life Quality Index (DLQI) in patients treated with AEMH (p < 0.001). The rate of repigmentation by VASI score improves from 96.25 ± 8.59 to 48.30 ± 28.16 after the treatment (p < 0.001). Treatment outcomes were comparable between the patients of segmental and stable nonsegmental vitiligo. The face and neck region achieved a better outcome, followed by the trunk (chest, abdomen, back, and axilla), limbs, and the worse outcome was found in the acral region (p < 0.014). Conclusively, AEMH is an effective treatment procedure with limited adverse events in patients with stable vitiligo. This harvesting method may be a feasible option for vitiligo surgical treatment.