Failure of the Dermomine Smart Micrografting Kit in Acral Finger Vitiligo: A Prospective Interventional Study of 18 Patients: A Prospective Single-Center Null-Outcome Trial

Abstract

Acral vitiligo lesions are often resistant to conventional treatment methods, which leads to a significant deterioration in the quality of life for individuals affected by this condition. Vitiligo in the fingers represents one of the most refractory forms of vitiligo. Several clinical trials and studies  are continuously assessing new treatment modalities including invasive and non-invasive methods, The use of an autologous suspension of regenerative skin cells and mesenchymal stem cells obtained from unaffected, normally pigmented skin is a promising approach, the final effectiveness of which remains to be determined in clinical trials. The objective of this study is to assess the effectiveness of Dermomine system in treatment of acral vitiligo of the fingers among group of Iraqi patients who were having vitiligo for more than 10 years and failed to respond to conventional treatment with phototherapy or topical agents. The study included 18 patients who met the inclusion criteria aged between 20-50 years. All fingers except thumbs were treated with intradermal injection of the Dermomine cell suspension across three sessions at four-week intervals. Thumbs were injected with normal saline as an intra-patient control. Patients were followed up for 6 months after the last treatment session on scheduled visits. Repigmentation and response to treatment were assessed through standardized digital photographs before and after treatment, digital photographs were compared , baseline,3 months and 6 months after last treatment session. Our assessment revealed that this procedure was not effective treatment method failed to enhance repigmentation in the affected area. The repigmentation percentage was zero during the whole follow-up period. The intradermal injection procedure at acral sites was associated with considerable pain particularly upon needle withdrawal. In conclusion, Dermomine smart micrografting kit is completely  ineffective treatment method in acral vitiligo of the fingers, it failed to produce repigmentation and was associated with moderate to severe pain during intradermal injection and pain intensified on needle withdrawal. The failed repigmentation could be due mechanical disaggregation which may causes disruption of the melanocyte stem cell niche, lack of follicular engraftment in the acral skin, immune-mediated melanocyte destruction and improper preparation of the recipient site and adjuvant phototherapy

Keywords: Acral Finger Vitiligo, Treatment , Dermomine Smart Micrografting Kit, Outcome, Failure