Vitiligo
Conditions
Keywords
Vitiligo, Outer-Root-Sheath, Melanocytes, Hair Follicles
Brief summary
The purpose of this study is to evaluate the hypothesis that, in patients with stable vitiligo unresponsive to conventional treatments including traditional phototherapy and/or topical steroids, the application of a non-cultured autologous hair follicle outer-root-sheath melanocytes suspension in the area affected by the disease followed by targeted ultraviolet B (UVB) phototherapy can lead to a significant skin repigmentation. To assess the effect of the proposed treatment, a within-subject controlled study involving selected symmetric lesion areas localized to the back of the hands will be conducted.
Interventions
The treatment consists in depositing a suspension of autologous outer-root-sheath melanocytes, derived from patient's plucked hair follicles, and patient's own serum on the area affected by vitiligo, after properly preparation with dermabrasion. Afterwards a targeted UVB phototherapy will be carried out by patients at home for 3 days / week from the beginning of the 5th week after transplantation till the end of the study period (12th week).
The treatment consists in depositing a solution made of saline and patient's own serum on the area affected by vitiligo, after properly preparation with dermabrasion. Afterwards a targeted UVB phototherapy will be carried out by patients at home for 3 days / week from the beginning of the 5th week after transplantation till the end of the study period (12th week).
Sponsors
Study design
Eligibility
Inclusion criteria
* Presence of symmetric lesions of vitiligo at the back of the hands with an extension \>5cm² * Vitiligo lasting at least one year at the backs of both hands * Stable vitiligo, defined as vitiligo that presents no evident evolution (appearance of new lesions or increase in the extension of lesions already present) for at least 6 months * Suspension for at least two months prior to the enrollment date of any systemic drug for vitiligo such as immunosuppressive treatment (cyclosporine, systemic steroids) or psoralen + ultraviolet A therapy, phototherapy with ultraviolet B, and of any anticoagulant drug * Suspension of topical medications for at least 15 days prior to the enrollment date
Exclusion criteria
* Presence of active vitiligo or Koebner phenomenon * Difference of more than 10% in the extension of symmetrical areas of vitiligo * Presence of systemic infections or infections localized to the tissues intended for transplantation * History of infections to the tissues intended for transplantation (herpes simplex, human papillomavirus infections, pityriasis versicolor, pityriasis alba) * Presence or history of malignancy * Chemotherapy or radiation therapy in progress * History of allergies or adverse reactions to local anesthetics * Presence of transmissible diseases (human immunodeficiency virus, hepatitis B and C, human T-lymphotropic virus type I and II, syphilis, cytomegalovirus, Creutzfeldt-Jacob, tuberculosis) * Women who are pregnant or intend to become pregnant during the study period (including breastfeeding women)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Repigmentation equal to or greater than 50% of the treated areas from baseline as assessed by image analysis | 12 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Any repigmentation of the treated areas from baseline as assessed by physician according to an ordinal 6-points scale | 6 weeks, 12 weeks |
| Any repigmentation of the treated areas from baseline as assessed by patient according to an ordinal 6-points scale | 6 weeks, 12 weeks |
| Overall patient satisfaction to the proposed therapy as assessed by visual analogue scale | 6 weeks, 12 weeks |
| Any repigmentation of the treated areas from baseline as assessed by image analysis | 6 weeks, 12 weeks |
| Any repigmentation of other areas affected by vitiligo from baseline as assessed by physician according to an ordinal 6-points scale (evaluation of a possible systemic effect) | 6 weeks, 12 weeks |
Countries
Italy