Consensus statement on the surgical management of vitiligo

Vitiligo is a chronic skin disorder characterized by the loss of melanocytes, leading to depigmented patches on the skin. The global lifetime prevalence of vitiligo diagnosed by a physician or dermatologist was estimated at 0•36% in the general population, 0•67% in the adult population adults, and 0•24% in the child population. Vitiligo prevalence was higher in adults than in children across all regions. Central Europe and south Asia reported the highest prevalence 0•52% and 0•52%, respectively, in the general population. Vitiligo significantly impacts patients' quality of life, causing psychological distress and social stigmatization. While medical treatments such as corticosteroids and phototherapy exist, they often fail to achieve satisfactory repigmentation, particularly in extensive or recalcitrant cases. In recent years, surgical interventions have gained prominence as effective alternatives for managing vitiligo. Techniques such as autologous melanocyte transplantation, suction blister grafting, split-thickness skin grafting, and punch grafting offer promising repigmentation results. However, the lack of standardized protocols and guidelines for vitiligo surgery presents challenges in patient selection, procedural approaches, and post-operative care. This study aims to review current surgical techniques, assess patient-specific factors influencing surgical success, and evaluate long-term outcomes, including repigmentation rates and patient satisfaction. Key factors include disease stability, lesion characteristics, and the involvement of exposed areas. Moreover, the study emphasizes the importance of post-operative adjuvant therapy, such as topical tacrolimus and excimer therapy, to enhance surgical outcomes. By establishing evidence-based protocols for vitiligo surgery, this study seeks to improve treatment efficacy and patient care, addressing gaps in current practices and advancing the field toward more consistent and successful outcomes in vitiligo management.