Abstract
BACKGROUND: Stable vitiligo, characterized by irreversible melanocyte loss, often resists conventional therapies. Non-cultured epidermal cell suspension (NCES) transplantation are increasingly used, and adjunctive autologous serum may enhance efficacy via growth factor-mediated cell survival and proliferation. This study evaluates the clinical outcomes of combined autologous serum and NCES therapy for stable vitiligo. METHODS: This prospective case series enrolled 30 patients (61 sites) with stable vitiligo at the Guangzhou New Centre Institute of Vitiligo (2024-2025). Patients received autologous serum followed by NCES transplantation. Repigmentation was assessed using the Vitiligo Area Scoring Index (VASI) and color matching. Adverse events were monitored. RESULTS: After 3 to 6 months, excellent repigmentation (> 90%) was achieved in 83.6% of treated sites (51/61), with particularly high efficacy on facial (90% efficacy in 9/10 sites) and neck regions (92.3% efficacy in 12/13 sites). The trunk, upper limbs, and hands/fingers exhibited excellent repigmentation in 80.0%, 77.8%, and 78.6% of sites, respectively. Poor repigmentation (< 25%) was observed in only one trunk site (1/61). Excellent color matching was achieved in 82.0% of treated sites (50/61), and no treatment-related adverse effects were reported. CONCLUSION: The combination of autologous serum and NCES transplantation is highly effective and safe for stable vitiligo. Autologous serum may synergize with NCES by supporting the microenvironment for melanocyte engraftment, offering a promising strategy for stable vitiligo.