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]

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Media Gallery

Distinguished physician with mark of distinction, a white forelock that his father and grandfather also shared.

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Author

Camila K Janniger, MD Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, Rutgers New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Michael D Fox, MD Attending Physician, Department of Emergency Medicine, Marin General Hospital

Michael D Fox, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Geriatrics Society, American Academy of Family Physicians, California Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Albert C Yan, MD Section Chief, Associate Professor, Department of Pediatrics, Section of Dermatology, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine

Albert C Yan, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology, Society for Pediatric Dermatology, American Academy of Pediatrics

Disclosure: Nothing to disclose.

Piebaldism Treatment & Management

Medical Care

Surgical Care

References

Tables

Contributor Information and Disclosures

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