Inoculation of a cultured autologous epidermal suspension containing melanocytes in vitiligo.

To the Editor.— Among the various medical therapies used for vitiligo, psoralen plus UV-A (PUVA) is widely accepted because of its effectiveness. But prolonged treatment and partial or nonprogressiveness in a few types of lesions, especially of acrofacial and mucosal types, are the main limiting factors. For the relatively refractory types of vitiligo, alternative therapies are needed. Recently, successful culturing of melanocytes has made it possible to transplant cultured melanocytes for repigmentation in vitiligo lesions.1-3However, the use of certain growth enhancers like phorbol esters, which are known tumor promoters, in culture media warrants the risk in patients. Gilchrest et al4successfully cultured melanocytes without phorbol esters. Falabella1succeeded in producing pigment in vitiligo lesions by grafting cultured epidermis-bearing melanocyte sheets without using phorbol esters during a melanocyte culture procedure. Modifying these procedures, pigmentation was successfully produced in three patients with vitiligo by injecting a cultured