毛囊单位或单株毛囊移植治疗毛发部位白癜风疗效观察  

Efficacy of single-hair follicular unit transplantation in the treatment of vitiligo in hair-bearing areas

作　　者：陆振中[1] 石磊[1] 黄旻华 吴燕[1] 潘素花 周萍[1] 宗阳春 胡凯[2] 卞姝姝 夏俊杰[2] 严道金[2] 

机构地区：[1]苏州市吴中人民医院皮肤外科,215128 [2]解放军第454医院皮肤科

出　　处：《国际皮肤性病学杂志》2015年第6期348-350,共3页International Journal of Dermatology and Venereology

基　　金：苏州市科技计划项目（SYS201271）

摘　　要：目的探讨毛囊单位或单株毛囊移植治疗毛发部位白癜风和皮肤镜观察临床疗效的意义。方法以同期接受外用药物治疗的患者作对照，通过皮肤镜检查客观判断、比较毛发部位白癜风采用毛囊单位或单株毛囊移植与对照组的疗效。结果毛囊单位或单株毛囊移植移植治疗毛发部位白癜风的疗效明显优于外用药物治疗组。46处接受移植治疗的皮损中，有12处移植毛囊周围的色素完全恢复，白发消退，显效率54．3％。皮肤镜下最早在术后4周时就可看到毛囊周围色素恢复，并逐渐扩展、融合，色素恢复平均时间9．8周，明显早于肉眼观察到皮肤表面色素恢复时间（平均14．5周）。移植后白斑处皮肤微循环得到明显改善，肤质变软、纹理清晰，但与毛囊周围色素岛出现无相关性。患者术后未出现切口明显的瘢痕形成、感染等并发症。结论毛囊单位或单株毛囊移植治疗毛发部位白癜风疗效确切，同时使白斑和白发复色，手术安全，操作简单。Objective To evaluate the efficacy of single-hair follicular unit transplantation in the treatment of vitiligo in hair-bearing areas, and to estimate the performance of dermoscopy in efficacy evaluation. Methods Eighty-nine patients with vitiligo in hair-bearing areas were divided into two groups： a treatment group （38 patients with 46 vitiligo lesions） receiving single-hair follicular unit transplantation, a control group （51 patients with 67 vitiligo lesions） treated with topical drugs. Follow up visits were scheduled every 4 weeks for 24 weeks. The growth of epidermal melanocytes and degree of repigmentation were evaluated by both dermoscopy and naked eyes at every visit. Results A better outcome was achieved in the treatment group compared with the control group. Of the 46 vitiligo lesions receiving transplantation, 12 achieved complete repigmentation of white hairs and skin around transplanted hair follicles, with a marked response rate of 54.3%. Perifollicular repigmentation was seen by dermoscopy as early as 4 weeks after the transplantation, and gradually expanded and coalesced thereafter. The average time required for the appearance of repigmentation was 9.8 weeks by dermoscopy, markedly shorter than that by naked eyes （14.5 weeks）. After transplantation, microcirculation in vitiligo lesions was improved obviously, skin was softened, and skin texture became clear, but no correlation was observed with the appearance of perifollicular pigmentation islands. No complications such as scarring or infection occurred at incision sites after the operation. Conclusion Single-hair follicular unit transplantation is safe, simple to operate, and effective for the treatment of vitiligo in hair-bearing areas.

关 键 词：白癜风 毛发 毛囊 移植 皮肤镜 

分 类 号：R758.41[医药卫生—皮肤病学与性病学]