Punch implants, cultured melanocyte implants, thin implants of split thickness skin and grafts of cultured epidermal have also included in surgical treatment of skin disorder disease (vitiligo). Although the results are variable but have been encouraging and improvement through cosmetics has always been less ideal.

This experiment was done by Italian investigators who used the biopsies of donor having length of 0.5 cm2 to 4 cm2 to optimize the autografting technique of cultured epidermal and tried to attain the comparatively normal ratio of keratinocyte / melanocyte in the epidermal grafts. Thirty two such patients were selected for the experiment of this study and gone through the therapy of cultured epidermal autograft that were not having any improvement in vitiligo disease since last 18 months and minimum 2 of standard therapeutic treatments had failed and who did not receive any therapy since last 12 months.

The grafts were kept in position with the help of dressing alone on 105 vitiliginous sites having total affected area of 6078 cm2 on which an electrosurgical timedsurgery was de-epithelialized. 30 to 400 keratinocytes were included in each optimized epidermal culture. After the follow ups of around one to three months, repigmentation was persisted on the 77% of the total area which got treatment. The average repigmentation which persisted was around 31% in those seven patients which got further development in their patches during follow up.

Persisted repigmentation was depended on the anatomic site like periorbital and perioral areas with persistence level of 35% and on feet and hands it was 8% which was the worst rates but the repigemntation ratio was excellently better on all other areas with 88% to 96%, on the 25 remaining patients which were having stable vitiligo. Rate of matching color was also good and no disfigurement developed.