الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Vitiligo is a common acquired disorder and occurs in about 1% of world population. It is presented as patchy white depigmented lesions which gradually progress over many years. It occurs at any age but 70 to 80% of cases occur below the age of 30 years.
There are various hypotheses for the pathogenesis of vitiligo the most accepted included:
Autoimmune, genetic, neuronal and autocytotoxic hypotheses.
Vitiligo can be classified into:
1- Localized which may be local or segmental.
2- Generalized which may be symmetrical bilateral, acrofacial, universalis and vulgaris.
Different methods of treatment have been used in treatment of vitiligo which included:
I Medical treatment
-Photochemotherapy
- PUVA
- Khellin +UVA
- UVB (broad band UVB and narrow band UVB)
- Corticosteroid therapy (mainly topical steroids)
II Surgical treatment:
When vitiligo becomes resistant to medical treatment, surgical treatment is considered if stability is obtained.
- Dermabrasion followed by 5- flurouracil cream application.
- Grafting techniques: like thin Theirsh grafts, epidermal grafting, minigrafting and melanocytes transplantation.
- Micropigmentation (tattooing).
III Additional therapies including:
- Sunscreens.
- Cosmetics.
The aim of the study was to evaluate the effectiveness of using minigrafting alone or in combination with narrow band UVB phototherapy for treatment of cases with stable, refractory, localized or segmental vitiligo and to compare both techniques as regards repigmentation and its extent and the rate of success of both techniques.
This study was carried out on 20 patients with non progressive, stable vitiligo. They were selected having stable vitiligo for at least one year duration, and they showed resistance to previous medical treatment or phototherapy.
Patients were subjected to the following:
- Complete history taking.
- General examination.
- Dermatological examination.
The studied cases were categorized into two groups, each group included 10 patients and they were managed as follows:
The 1st group of patients was treated by minigrafting using punch biopsy; the 2nd group of patients was treated by minigrafting in combination with narrow band UVB.
The patients were followed up every week after surgical interference, for a period of 6 months.
Conclusions and recommendations
After interpretation of the results obtained, the following conclusions could be obtained:
- Surgical treatment of vitiligo is suitable for patients who tried medical therapy for a long time without any benefit and their disease is stationary.
- The minigrafting technique is easy to perform, inexpensive and the incidence of infection is very low when compared with the other melanocytes grafting techniques.
- Minigrafting technique is rapid and highly effective in patients with segmental vitiligo compared to those with focal vitiligo.
- The combination of narrow band UVB and minigrafting resulted in complete, homogenous and more acceptable repigmentation, also this combination lead to decrease the dosage of phototherapy and its drawbacks.
- It is recommended that, further research studies must be done on larger number of vitiligo patients and for longer follow up periods for logistic evaluation of the durability of these surgical modalities utilized in treatment of this disorder with great impact on patient’s physical appearance.