Effect of platelet-rich plasma on the outcome of mini punch grafting procedure in localized stable vitiligo: clinical evaluation and relation to lesional basic fibroblast growth factor.

Salem, Samar Abdallah M; Fezeaa, Tabarek Abdulkhaleq; El Khazragy, Nashwa; Soltan, Marwa Y

Surgical methods are favorably used for treatment of stable vitiligo, and platelet-rich plasma (PRP) can be added to augment the effect. The additive value of PRP; however, remains elusive. Basic fibroblast growth factor (bFGF) is released from activated platelets with a capacity for stimulating melanocyte proliferation and migration. We aimed to assess the treatment outcomes for the mini punch grafting (MPG) / phototherapy treatment with and without PRP and to evaluate the relation between bFGF and the obtained results. Thirty-four vitiliginous patches, two per each patient with stable vitiligo, were enrolled in this intra-patient-controlled study and treated with autologous MPG and subsequent exposure to phototherapy with and without enhancement via PRP procedure at the time of the procedure, and monthly for the subsequent 3 months. Re-pigmentation assessment via vitiligo scores as well as measurement of lesional bFGF were done. PRP assistance to MPG/phototherapy treatment resulted in earlier re-pigmentation at week 8. However, this enhancement effect vanished at the study end (week 20) as ideal re-pigmentation (> 75% re-pigmentation) was encountered in 10 patches (58.8%) treated with MPG/phototherapy modality, and in 12 patches (70.6%) treated with PRP-assisted method without significant difference between them. Lesional bFGF increased after both treatments with a higher expression with PRP assistance but without clinical reflection on the final outcome. PRP can speed the re-pigmentation response for MPG/phototherapy procedure without any significant effect on the final outcome.