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Efficacy of Platelet Rich Plasma after Skin Needling in the Treatment of Vitiligo

Rofaida Mahmoud Abdelaty

Vitiligo is an idiopathic disorder in which the selective destruction of skin melanocytes results in the development of depigmented patches. It affects 0.5-1 % of the general population without any racial, sexual or regional differences in prevalence. The etiology of vitiligo has not yet been fully established; therefore, different factors are said to be potentially involved, including autoimmune, neural, genetic and biochemical hypotheses.

Platelet rich plasma (PRP) is the autologous preparation of platelets in condensed plasma. Various growth factors, including a platelet-derived growth factor, a transforming growth factor, a vascular endothelial growth factor, and an insulin-like growth factor, are excreted from a-granules of condensed platelets triggered by aggregation inducers.

These factors are known to control many processes, including cell migration, attachment, proliferation, differentiation, and the promotion of extra cellular matrix aggregation through binding to various cell surface receptors.

Micro needling is an office technique that produces thousands of microchannels across the epidermis in the papillary dermis. This tiny wounds in the papillary dermis produce a confluent surface bleeding region that is an effective catalyst to initiate the natural process of wound healing with the release of multiple growth factors. These growth factors stimulate the migration and proliferation of fibroblasts that promote collagen deposition.

This research was conducted to assess the role of autologous PRP with skin needling in the treatment of vitiligo in a group of (26) Vitiligo patients who were exposed to the use of freshly prepared autologous Platelet Rich Plasma (PRP) double spinning technique every 2 weeks for 8 sessions. Results were evaluated quantitatively using the vitiligo area severity index (VASI) score and qualitatively by the percentage of repigmentation as excellent (> 75%), good (50-75%), moderate (25-50%), and mild (<25%).

There was a statistically meaningful drop in the VASI score in post-treatment patients relative to pre-treatment with a mean reduction of 8.21 %. No lasting side effects have been found in all patients. Transient ecchymosis has been identified in only one perioral area patient with injection.