Skin grafting is the transfer of normal, pigmented skin from one area
of the patient's body (donor sites) to an area of Vitiligo. The normal
skin's healthy melanocytes can then lead to partial repigmentation in
white spots as early as 4 to 6 weeks after grafting.

There are two major types of skin grafting techniques:


Autologous Skin Grafts - Small areas of unaffected skin (about 2mm) are
transferred using the punch graft method to affected areas of skin.

Punch Graft Method - Donor skin is taken from the buttock, thigh,
or leg with a 4mm skin bipsy punch and is placed on the recipient
area prepared by removing the Vitiliginous skin with a 3mm skin
biopsy punch.

Epidermal Skin Grafts - Basically the same procedure as Autologous skin
grafts, except for the process of recieving donor skin. Donor skin is
acquired through suction blisters. This procedure has a smaller risk of
scarring.

Suction Blister Method - Blisters are created on the patient's
pigmented skin by using heat, suction, or freezing cold. The tops
of blisters are then cut out and transplanted to Vitiligo-affected
areas.

Both techniques may lead to the development of a "cobblestone" appearance or
spotty pigmentation.



Skin grafting is only available in certain areas of the country and is
useful for only a small group of Vitiligo patients. It is an option for
patients with small, stable patches of Vitiligo or for patients with new
and recent patches.

Pigment tends to spread faster in lesions situated on the trunk, neck,
face, and proximal parts of the extremities. In contrast, pigment spreads
slower in lesions on the dorsal aspects of hands, fingers, feet and malleoli
(the round bone protrusions on either side of the ankle).


Side Effects:

Infections at donor or recipient sites
Scarring
Uneven appearance or "cobblestone" effect
Lack of repigmentation (though repigmentation happens 90% of the time)