Piebaldism Treatment & Management

Updated: Jun 09, 2022
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Medical Care

Depigmented skin in piebaldism is generally considered unresponsive to medical or light treatment. In 12 adults, dermabrasion and thin split-skin grafts were applied initially, with residual leukodermic patches subsequently treated using a minigrafting method. [31] Additional irradiation with ultraviolet A (10 J/cm2) was provided. This new combined approach led to 95-100% repigmentation of the leukoderma. An almost perfect color match with the surrounding nonlesional skin was noted in all cases; therefore, dermabrasion and split-skin grafting followed by minigrafting may be a good option for selected patients. Autologous punch grafting for repigmentation in piebaldism may be considered in selected individuals. [32]  Another option is autologous cell suspension transplantation using a cell extraction device. [33]


Surgical Care

Surgical approaches may be considered for patients with stable vitiligo. [34, 35] Surgical transplant may use noncultured cellular grafting, which can repigment vitiligo 5-10 times the size of the donor skin and can be completed on the same day in an outpatient setting. Autologous noncultured cell suspension transplantation can be used with superficial full-surface ablation to a depth of 144 μm recommended as an effective recipient site preparation prior to cell suspension transplantation. [36]  Donor-to-recipient ratios need to be considered in surgical treatment of piebaldism. [37]