Epidermal Grafts for Lip Vitiligo

The involvement of the lips in vitiligo is a common occurrence in black races and may occur in 20% of patients with vitiligo. Vitiligo lesions involving the lips are resistant to medical therapies as no melanocyte reservoir exists because of an absence of hair follicles. Hence, surgical replenishment of melanocytes is the only option available. We used melanocyte transfer via autologous epidermal grafts for the treatment of stable vitiligo of the lips.

Treatment of mucosal vitiligo is a big challenge in treating the vitiligo. As the lip has no melanocyte reservoir in the form of hair follicles. Medical management of lip vitiligo often show a poor result according to our study. And eventually the lips may fail to repigment the vitiligo on the lips. Even though the micropigmentation (tattooing) gives immediate results, but subsequent the fading or discoloration may occur on the lips, so it have a poor effect. Sometimes there might have some potential adverse effect. The cosmetic outcome with individual procedures also varies significantly. The success rate of various autografting procedures for lip vitiligo varies from 0% to 100%. The highest success rates have been reported with thin split thickness grafting and micropigmentation, however, the number of patients treated by these two procedures is very small, suggesting that they are not very popular for the management of lip vitiligo, probably due to a less than optimal aesthetic outcome.

In our opinion, surgical treatment speeds up repigmentation, thereby avoiding frustration for both patients and doctors. Melanocyte transfer, as described in this study, may be the most aesthetically suitable surgical therapeutic option for lip vitiligo.