Surgical Approach to Vitiligo in Indian population

Vitiligo, characterized by depigmented macules is a common disorder in our country with a high psychosocial impact. The social stigma, associated with it, is enormous. The patients are very anxious to get rid of the disease at the earliest. Surgical treatment is indicated in resistant stable vitiligo where it does not show adequate response to medical therapy. Stability of the disease process is the most important parameter for achievement of a successful outcome. Conventional surgical modalities are tissue grafts such as punch grafting, suction blister grafting and split thickness skin grafts. The choice of surgical treatment depends on type of vitiligo, extent and site of lesions, availability of equipment and expertise of the treating surgeon. Split thickness skin grafting has been considered the most successful out of all tissue grafting methods. Recent advances include autologous non-cultured epidermal cell suspensions and cultured melanocyte suspensions or sheets. Hence though surgical treatment of vitiligo is evolving over the years, the basic etiopathogenetic mechanisms need to be elucidated to achieve long term successful results.