Motorized 0.8-mm micropunch grafting for refractory vitiligo: A retrospective study of 230 cases

Background Punch grafting for vitiligo is time-consuming and can result in cobblestone-like appearances. We devised a motorized 0.8-mm micropunch grafting procedure to overcome these limitations. Objective To assess the therapeutic effectiveness and adverse events associated with micropunch grafting in refractory vitiligo. Methods We retrospectively reviewed 230 cases in 208 patients with stable vitiligo who underwent motorized 0.8-mm micropunch grafting during January 2015-August 2017. Treatment success was defined as ≥75% repigmentation, and factors associated with the outcome were assessed. Results Overall, 181 of 230 lesions (78.7%) achieved treatment success after a median of 6 months with postoperative excimer therapy. Lesions on the face and neck, and disease stability of ≥12 months were good prognostic factors for treatment success. Common adverse events were color mismatch (24.8%) and cobblestone appearance (18.3%). Overall, the treatment was tolerable. Limitations This was a retrospective study. Conclusion Micropunch grafting using a motorized 0.8-mm punch can successfully treat refractory vitiligo with short procedure times and excellent outcomes. This technique could be a rapid and convenient surgical option with acceptable adverse events and is promising for treating refractory vitiligo on an outpatient basis, particularly in patients who are unlikely to tolerate prolonged surgery.