vitiligo AND repigmentation

vitiligo complete repigmentation case report complete cure site:pubmed.ncbi.nlm.nih.gov OR site:pmc.ncbi.nlm.nih.gov

vitiligo AND "complete repigmentation"

vitiligo AND "100% repigmentation"

vitiligo AND transplantation AND repigmentation

vitiligo AND ruxolitinib AND repigmentation

https://pmc.ncbi.nlm.nih.gov/articles/PMC4601414

PMID: 40123791

PMID: 37701552

PMID: 32491188

PMID: 24023436

PMID: 15492182

PMID: 32653055

PMID: 39509558

PMID: 41804555

guideline vitiligo treatment complete repigmentation not cure recurrence repigmentation consensus 2025

https://pmc.ncbi.nlm.nih.gov/articles/PMC11928802

PMID: 29103774

PMID: 10325459

~/

mkdir -p "/tmp/workspace/vitiligo-complete-repigmentation/src" "/tmp/workspace/vitiligo-complete-repigmentation/output"

python3 - <<'PY' from pathlib import Path p=Path('/tmp/workspace/vitiligo-complete-repigmentation/src/create_report.py') p.write_text(r'''from docx import Document from docx.shared import Inches, Pt, RGBColor from docx.enum.text import WD_ALIGN_PARAGRAPH from docx.enum.section import WD_SECTION from docx.oxml import OxmlElement from docx.oxml.ns import qn from docx.enum.table import WD_TABLE_ALIGNMENT, WD_CELL_VERTICAL_ALIGNMENT from docx.enum.style import WD_STYLE_TYPE OUT='/tmp/workspace/vitiligo-complete-repigmentation/output/Vitiligo_Complete_Repigmentation_Evidence_Compilation.docx' def shade(cell, fill): tcPr=cell._tc.get_or_add_tcPr(); shd=OxmlElement('w:shd'); shd.set(qn('w:fill'),fill); tcPr.append(shd) def set_cell_text(cell,text,bold=False,size=8.2): cell.text=''; p=cell.paragraphs[0]; p.paragraph_format.space_after=Pt(0) r=p.add_run(text); r.bold=bold; r.font.size=Pt(size) cell.vertical_alignment=WD_CELL_VERTICAL_ALIGNMENT.TOP def add_link(paragraph, text, url): part=paragraph.part; rid=part.relate_to(url,'http://schemas.openxmlformats.org/officeDocument/2006/relationships/hyperlink',is_external=True) h=OxmlElement('w:hyperlink'); h.set(qn('r:id'),rid) r=OxmlElement('w:r'); rp=OxmlElement('w:rPr'); col=OxmlElement('w:color'); col.set(qn('w:val'),'0563C1'); rp.append(col); ul=OxmlElement('w:u'); ul.set(qn('w:val'),'single'); rp.append(ul); r.append(rp) t=OxmlElement('w:t'); t.text=text; r.append(t); h.append(r); paragraph._p.append(h) def citation(p, author, year, title, journal, pmid, doi=None): p.add_run(f'{author} ({year}). {title}. {journal}. ') add_link(p,f'PMID: {pmid}',f'https://pubmed.ncbi.nlm.nih.gov/{pmid}/') if doi: p.add_run('. DOI: '+doi) doc=Document(); sec=doc.sections[0]; sec.top_margin=Inches(.7); sec.bottom_margin=Inches(.7); sec.left_margin=Inches(.7); sec.right_margin=Inches(.7) styles=doc.styles; styles['Normal'].font.name='Arial'; styles['Normal'].font.size=Pt(10) for s in ['Title','Heading 1','Heading 2']: styles[s].font.name='Arial'; styles[s].font.color.rgb=RGBColor(31,78,121) styles['Title'].font.size=Pt(22) p=doc.add_paragraph(); p.alignment=WD_ALIGN_PARAGRAPH.CENTER r=p.add_run('Published Evidence of Complete or Near-Complete Repigmentation in Vitiligo'); r.bold=True; r.font.name='Arial'; r.font.size=Pt(20); r.font.color.rgb=RGBColor(31,78,121) p=doc.add_paragraph(); p.alignment=WD_ALIGN_PARAGRAPH.CENTER; r=p.add_run('Curated evidence compilation - literature search completed 27 September 2026'); r.italic=True; r.font.size=Pt(10) doc.add_heading('Executive finding',1) p=doc.add_paragraph() p.add_run('“Complete cure” is not an evidence-based outcome label for vitiligo. ').bold=True p.add_run('Published reports document complete or 100% repigmentation of specific treated patches, and occasionally broader areas, but vitiligo is a chronic autoimmune condition and relapse can occur after apparent clinical clearance. This compilation therefore uses the precise outcome reported by authors: complete/100% repigmentation, near-complete repigmentation, or 90-100% repigmentation. It does not equate patch clearance with permanent whole-body cure.') p=doc.add_paragraph(style='List Bullet'); p.add_run('Best direct evidence of 100% clearance is mainly in stable, localized or segmental lesions treated with surgical melanocyte or follicular transplantation.').bold=True p=doc.add_paragraph(style='List Bullet'); p.add_run('The largest retrieved prospective series reported 90-100% repigmentation in 656 of 880 selected, test-graft-positive patients (74.55%) after miniature punch grafting, but selection and cosmetic complications limit generalizability.').bold=True p=doc.add_paragraph(style='List Bullet'); p.add_run('Medical therapy trials more commonly report threshold responses such as at least 50% or at least 75% repigmentation, not complete clearance. Whole-body cure was not established by the retrieved evidence.') doc.add_heading('Search scope and selection',1) doc.add_paragraph('Sources searched: PubMed, PubMed Central full text, indexed reference trails, and authoritative dermatology textbook content. Search concepts included: vitiligo AND complete repigmentation; 100% repigmentation; transplantation; follicular unit extraction; ruxolitinib; and repigmentation. Searches were conducted through 27 September 2026. This is a targeted evidence compilation, not a registered systematic review and cannot guarantee capture of every publication in every database or language.') doc.add_paragraph('Inclusion for the main table: a human publication that explicitly stated complete, 100%, or 90-100% repigmentation of vitiligo lesions, or reported a cohort outcome in that range. Outcomes are author-reported and may use clinical photographs, physician assessment, or unspecified methods. Excluded from the main table: papers reporting only partial improvement, mechanistic studies, and claims that could not be verified as complete/near-complete repigmentation.') doc.add_heading('Directly documented complete or near-complete outcomes',1) headers=['Evidence / patient(s)','Vitiligo setting','Intervention','Reported outcome and timing','Follow-up / key caveat'] rows=[ ['Case report - 1 patient\nChouhan et al., 2013\nPMID 24023436','Stable focal vitiligo patch with scarring and leukotrichia; 28-year-old man.','Follicular-unit extraction body-hair transplantation; phototherapy restarted after 1 week.','Complete pigmentation (100%) at 12 weeks; good colour match.','No recurrence reported at 3 months. Single small, selected patch, short follow-up.'], ['Case report - 1 patient\nPillai & Goyal, 2023\nPMID 37701552','Segmental vitiligo of chest/abdomen; residual depigmentation after first scalp FUE procedure.','Scalp then pubic follicular-unit extraction grafting plus NB-UVB photostimulation.','Complete repigmentation of the entire treated vitiligo area 7 months after second transplant.','Single case; grafted chest had persistent thick hairs from scalp grafts. Not evidence for generalized vitiligo.'], ['Case report - 1 patient\nZhu et al., 2015\nPMID 26538694','Extensive vitiligo after allogeneic bone marrow transplant; more than 50% BSA involved.','Four autologous non-cultured melanocyte-keratinocyte transplantation procedures after poor response to NB-UVB/tacrolimus.','First facial area: 100% at 8 months; second face: 98% at 8 months; neck sites 95% to nearly 100%. At 28 months, transplanted facial areas almost completely repigmented.','Highly exceptional clinical context. Outcomes apply to treated patches, not complete systemic clearance.'], ['Case report - 1 patient\nMumford et al., 2020\nPMID 32491188','Vitiligo in a patient with rheumatoid arthritis.','Oral baricitinib, reported in a letter/case report.','Published secondary evidence describes complete repigmentation in one case.','Primary abstract does not provide outcome detail in PubMed. Low-certainty single case; systemic JAK inhibitor risks require specialist assessment.'], ['Prospective series - 880 selected responders\nMalakar & Dhar, 1999\nPMID 10325459','Stable, recalcitrant vitiligo; 1,000 screened with test grafting, 880 test-graft-positive included.','Autologous miniature punch grafting.','656/880 (74.55%) achieved 90-100% repigmentation.','Not randomized; enrichment by a positive test graft. Polka-dot appearance 43.98%; colour mismatch 34.32%. “90-100%” is not necessarily 100% in every case.'], ] t=doc.add_table(rows=1, cols=len(headers)); t.alignment=WD_TABLE_ALIGNMENT.CENTER; t.style='Table Grid' for i,h in enumerate(headers): set_cell_text(t.rows[0].cells[i],h,True,8); shade(t.rows[0].cells[i],'1F4E79') for cell in t.rows[0].cells: for r in cell.paragraphs[0].runs:r.font.color.rgb=RGBColor(255,255,255) for row in rows: c=t.add_row().cells for i,val in enumerate(row): set_cell_text(c[i],val,False,7.6) for row in t.rows: for c in row.cells: c.width=Inches(1.3) doc.add_paragraph('Interpretation: The direct complete-repigmentation reports above predominantly concern stable, circumscribed lesions and surgical procedures. They demonstrate biological possibility and selected-patch success, not a dependable cure rate for all persons with vitiligo.',style='Caption') doc.add_heading('Context from higher-level evidence and controlled studies',1) context=[ ('Randomized controlled trial','van Geel et al., 2004, PMID 15492182','28 patients; 33 paired resistant lesions. Autologous non-cultured epidermal cell suspension versus placebo after laser ablation, with later UV exposure. In stable disease, at least 70% repigmentation occurred in 77% of actively treated lesions at 12 months; no at least-70% response in the uncertain-stability group. This supports disease stability as a key selection criterion, but does not establish universal 100% clearance.'), ('Clinical trial','Orouji et al., 2018, PMID 29103774','300 patients, 1,060 stable patches treated with autologous epidermal cell transplantation. At 9 months, more than 50% repigmentation occurred in 32.2% of patches; 79.3% of achieved repigmentation remained stable during follow-up to 30 months. Complete-response counts were not reported.'), ('Systematic review','Jafarzadeh et al., 2025, PMID 39509558','48 articles, 2,186 patients. Regenerative approaches showed meaningful repigmentation, especially non-cultured melanocyte-keratinocyte transplantation and hair follicle-derived cell techniques. Authors highlighted heterogeneity and substantial risk of bias: 48.84% of included studies had high overall risk of bias.'), ('Systematic review/meta-analysis','Xireaili et al., 2026, PMID 41804555','18 home-UVB studies, 1,341 patients. Home UVB was not inferior to office UVB for greater than 50% or greater than 75% repigmentation. The analysis does not show that UVB provides complete cure.') ] t=doc.add_table(rows=1,cols=3); t.style='Table Grid'; t.alignment=WD_TABLE_ALIGNMENT.CENTER for i,h in enumerate(['Design','Source','What it adds']): set_cell_text(t.rows[0].cells[i],h,True,8); shade(t.rows[0].cells[i],'1F4E79') for cell in t.rows[0].cells: for r in cell.paragraphs[0].runs:r.font.color.rgb=RGBColor(255,255,255) for row in context: c=t.add_row().cells for i,v in enumerate(row):set_cell_text(c[i],v,False,8) doc.add_heading('What the evidence supports - and does not support',1) for text in [ 'It supports that complete or near-complete repigmentation can occur in selected patches, particularly stable localized/segmental vitiligo treated surgically with melanocyte-containing grafts or hair-follicle grafts.', 'It supports that disease stability, lesion site, lesion size, presence of hair follicles, and treatment modality affect outcomes. Face, neck and trunk often respond better than acral sites.', 'It does not support claiming that any of these interventions permanently cures vitiligo for everyone. Case reports cannot establish frequency, causality, durability, or safety for broad use.', 'It does not support self-treatment with oral JAK inhibitors, systemic corticosteroids, 5-fluorouracil tattooing, transplantation, or UV devices. These require individualized dermatology assessment and monitoring.' ]: doc.add_paragraph(text,style='List Bullet') doc.add_heading('Textbook perspective',1) p=doc.add_paragraph('A dermatology textbook source states that total repigmentation is only rarely achieved because response differs by body site, and about 30% of patients may not respond despite months of therapy. ') p.add_run('Dermatology 2-Volume Set, 5th ed., “Treatment protocols and results,” lines 3469-3470.').italic=True doc.add_heading('References',1) refs=[ ('Chouhan K, Kumar A, Kanwar AJ','2013','Body hair transplantation in vitiligo','Journal of Cutaneous and Aesthetic Surgery','24023436','10.4103/0974-2077.112675'), ('Pillai J, Goyal N','2023','Repigmentation of segmental vitiligo with scalp and pubic follicular unit extraction graft transplantation','International Journal of Trichology','37701552','10.4103/ijt.ijt_41_22'), ('Zhu J, et al.','2015','Successful repigmentation of vitiligo after allogeneic bone marrow transplantation for Hodgkin’s lymphoma by autologous noncultured melanocyte-keratinocyte transplantation','Annals of Dermatology','26538694',None), ('Mumford BP, Gibson AA, Chong AH','2020','Repigmentation of vitiligo with oral baricitinib','Australasian Journal of Dermatology','32491188','10.1111/ajd.13348'), ('Malakar S, Dhar S','1999','Treatment of stable and recalcitrant vitiligo by autologous miniature punch grafting: a prospective study of 1,000 patients','Dermatology','10325459','10.1159/000018089'), ('van Geel N, et al.','2004','Double-blind placebo-controlled study of autologous transplanted epidermal cell suspensions for repigmenting vitiligo','Archives of Dermatology','15492182','10.1001/archderm.140.10.1203'), ('Orouji Z, et al.','2018','A single-arm open-label clinical trial of autologous epidermal cell transplantation for stable vitiligo: a 30-month follow-up','Journal of Dermatological Science','29103774','10.1016/j.jdermsci.2017.10.007'), ('Jafarzadeh A, Mohammad AP, Goodarzi A','2025','A systematic review of case series and clinical trials investigating regenerative medicine for the treatment of vitiligo','Journal of Cosmetic Dermatology','39509558','10.1111/jocd.16660'), ('Xireaili F, et al.','2026','The effectiveness of home-based phototherapy in vitiligo: a systematic review and meta-analysis','Photodermatology, Photoimmunology & Photomedicine','41804555','10.1111/phpp.70079'), ('Rosmarin D, et al.','2020','Ruxolitinib cream for treatment of vitiligo: a randomised, controlled, phase 2 trial','The Lancet','32653055','10.1016/S0140-6736(20)30609-7'), ] for args in refs: p=doc.add_paragraph(style='List Number'); p.paragraph_format.space_after=Pt(4); citation(p,*args) doc.add_heading('Evidence-grade note',1) doc.add_paragraph('Case reports are hypothesis-generating evidence, not proof of a reproducible cure. Surgical cohort and trial findings are more informative but are strongly dependent on patient selection and lesion-level outcome measurement. The evidence should be discussed with a board-certified dermatologist, especially where active disease, extensive body-surface involvement, pregnancy plans, immunosuppression, cancer history, or coexisting autoimmune disease are present.') # footer for section in doc.sections: footer=section.footer.paragraphs[0]; footer.alignment=WD_ALIGN_PARAGRAPH.CENTER footer.add_run('Vitiligo Complete Repigmentation Evidence Compilation | 27 Sep 2026 | For research and clinician discussion, not personal medical advice').font.size=Pt(8) doc.save(OUT) print(OUT) ''') PY python3 "/tmp/workspace/vitiligo-complete-repigmentation/src/create_report.py" python3 - <<'PY' from docx import Document p='/tmp/workspace/vitiligo-complete-repigmentation/output/Vitiligo_Complete_Repigmentation_Evidence_Compilation.docx' d=Document(p) print('paragraphs',len(d.paragraphs),'tables',len(d.tables)) print(d.paragraphs[0].text) print('size',__import__('os').path.getsize(p)) PY

python3 - <<'PY' from docx import Document from pathlib import Path p=Path('/tmp/workspace/vitiligo-complete-repigmentation/output/Vitiligo_Complete_Repigmentation_Evidence_Compilation.docx') d=Document(str(p)) all_text='\n'.join(x.text for x in d.paragraphs)+'\n'+'\n'.join(' | '.join(c.text for c in row.cells) for t in d.tables for row in t.rows) checks=['Complete pigmentation (100%) at 12 weeks','Complete repigmentation of the entire treated vitiligo area','656/880 (74.55%) achieved 90-100% repigmentation','“Complete cure” is not an evidence-based outcome label'] print('exists',p.exists(),'bytes',p.stat().st_size) for x in checks: print(x, x in all_text) print('tables:', [len(t.rows) for t in d.tables]) PY

~/

vitiligo before after complete repigmentation follicular unit extraction graft transplantation clinical photograph

PMC vitiligo 100% repigmentation before after clinical images hair transplantation

vitiligo AND repigmentation

https://pmc.ncbi.nlm.nih.gov/articles/PMC10495070/

https://pmc.ncbi.nlm.nih.gov/articles/PMC11412555/

PMID: 26538694

PMID: 37701552

PMID: 24023436

~/vitiligo-complete-repigmentation

python3 - <<'PY' import requests, re, os, tarfile, io from pathlib import Path base=Path('/tmp/workspace/vitiligo-complete-repigmentation/assets') base.mkdir(exist_ok=True) for pmc in ['PMC3764757','PMC10495070','PMC4601414','PMC11412555']: u=f'https://www.ncbi.nlm.nih.gov/pmc/utils/oa/oa.fcgi?id={pmc}' r=requests.get(u,timeout=30); print(pmc, r.status_code, r.text[:180]) m=re.search(r'<link href="([^"]+)"',r.text) if not m: continue link=m.group(1); data=requests.get(link,timeout=60).content out=base/(pmc+'.tar.gz'); out.write_bytes(data) d=base/pmc; d.mkdir(exist_ok=True) with tarfile.open(fileobj=io.BytesIO(data),mode='r:gz') as t: t.extractall(d) print(' extracted',len(list(d.rglob('*')))) PY

python3 - <<'PY' import requests for pmc in ['PMC3764757','PMC10495070','PMC4601414','PMC11412555']: u=f'https://www.ebi.ac.uk/europepmc/webservices/rest/{pmc}/fullTextXML' r=requests.get(u,timeout=30) print(pmc,r.status_code,len(r.content),r.text[:80]) open(f'/tmp/workspace/vitiligo-complete-repigmentation/assets/{pmc}.xml','wb').write(r.content) PY

python3 - <<'PY' from lxml import etree from pathlib import Path for f in Path('/tmp/workspace/vitiligo-complete-repigmentation/assets').glob('PMC*.xml'): root=etree.parse(str(f)); ns={'x':'http://www.w3.org/1999/xlink'} print('\n',f.name) for fig in root.xpath('//fig'): lab=' '.join(fig.xpath('./label//text()')); cap=' '.join(fig.xpath('./caption//text()')).strip(); gr=fig.xpath('.//graphic/@xlink:href',namespaces=ns) print(lab,gr,cap[:160]) PY

python3 - <<'PY' from lxml import etree from pathlib import Path for f in Path('/tmp/workspace/vitiligo-complete-repigmentation/assets').glob('PMC*.xml'): root=etree.parse(str(f)) print('\n'+f.name) for fig in root.xpath('//fig'): lab=' '.join(fig.xpath('./label//text()')); cap=' '.join(fig.xpath('./caption//text()')).strip(); gr=fig.xpath('.//*[local-name()="graphic"]/@*[local-name()="href"]') print(lab,gr,cap[:190]) PY

python3 - <<'PY' import requests from pathlib import Path base=Path('/tmp/workspace/vitiligo-complete-repigmentation/assets'); base.mkdir(exist_ok=True) items={'bodyhair':'https://pmc.ncbi.nlm.nih.gov/articles/PMC3764757/pdf/JCAS-6-111.pdf','segmental':'https://pmc.ncbi.nlm.nih.gov/articles/PMC10495070/pdf/IJT-15-70.pdf','mkt':'https://pmc.ncbi.nlm.nih.gov/articles/PMC4601414/pdf/IJD-60-470.pdf'} for n,u in items.items(): r=requests.get(u,headers={'User-Agent':'Mozilla/5.0'},timeout=60); print(n,r.status_code,r.headers.get('Content-Type'),len(r.content)) (base/(n+'.pdf')).write_bytes(r.content) PY python3 - <<'PY' import fitz from pathlib import Path base=Path('/tmp/workspace/vitiligo-complete-repigmentation/assets') for p in base.glob('*.pdf'): try: doc=fitz.open(p); print(p.name, len(doc), [len(x.get_images(full=True)) for x in doc]) except Exception as e: print('bad',p,e) PY

python3 - <<'PY' import requests from pathlib import Path base=Path('/tmp/workspace/vitiligo-complete-repigmentation/assets'); (base/'images').mkdir(exist_ok=True) items={ 'body_before':('PMC3764757','JCAS-6-111-g002.jpg'), 'body_after':('PMC3764757','JCAS-6-111-g004.jpg'), 'seg_before':('PMC10495070','IJT-15-70-g001.jpg'), 'seg_after':('PMC10495070','IJT-15-70-g006.jpg'), 'mkt_face':('PMC4601414','IJD-60-470-g003.jpg'), 'mkt_neck':('PMC4601414','IJD-60-470-g004.jpg'), 'follicular_beforeafter':('PMC11412555','prs-154-666e-g002.jpg'), 'follicular_vertex':('PMC11412555','prs-154-666e-g004.jpg')} for out,(pmc,file) in items.items(): urls=[f'https://pmc.ncbi.nlm.nih.gov/articles/instance/{pmc[3:]}/bin/{file}',f'https://www.ncbi.nlm.nih.gov/pmc/articles/PMC{pmc[3:]}/bin/{file}',f'https://pmc-oa-opendata.s3.amazonaws.com/{pmc}.1/{file}'] ok=False for u in urls: r=requests.get(u,headers={'User-Agent':'Mozilla/5.0'},timeout=30) if r.status_code==200 and r.headers.get('Content-Type','').startswith('image'): (base/'images'/(out+'.jpg')).write_bytes(r.content); print('OK',out,u,len(r.content));ok=True;break if not ok:print('FAILED',out,[(x,requests.get(x,headers={'User-Agent':'Mozilla/5.0'},timeout=10).status_code) for x in urls]) PY file /tmp/workspace/vitiligo-complete-repigmentation/assets/images/*

python3 - <<'PY' from pathlib import Path p=Path('/tmp/workspace/vitiligo-complete-repigmentation/src/build_illustrated_reports.py') p.write_text(r'''from pathlib import Path from PIL import Image from reportlab.lib.pagesizes import A4 from reportlab.lib import colors from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.units import cm from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, PageBreak, Image as RLImage, Table, TableStyle, KeepTogether from reportlab.pdfbase.pdfmetrics import stringWidth from reportlab.lib.enums import TA_CENTER from docx import Document from docx.shared import Inches, Pt, RGBColor from docx.enum.text import WD_ALIGN_PARAGRAPH ROOT=Path('/tmp/workspace/vitiligo-complete-repigmentation') AS=ROOT/'assets'/'images'; OUT=ROOT/'output' PDF=OUT/'Vitiligo_Complete_Repigmentation_Illustrated_Evidence_Report.pdf' DOCX=OUT/'Vitiligo_Complete_Repigmentation_Evidence_Compilation_Illustrated.docx' orig=OUT/'Vitiligo_Complete_Repigmentation_Evidence_Compilation.docx' # Convert CMYK source images to RGB for dependable PDF/DOCX embedding for im in AS.glob('*.jpg'): x=Image.open(im) if x.mode!='RGB': x.convert('RGB').save(im.with_suffix('.png')) cases=[ {'title':'Case A: Body-hair follicular-unit transplantation','before':'body_before.jpg','after':'body_after.jpg','citation':'Chouhan K, Kumar A, Kanwar AJ. Body Hair Transplantation in Vitiligo. J Cutan Aesthet Surg. 2013;6(2):111-112. PMID: 24023436. PMCID: PMC3764757.','source':'Figure 2(a), pre-surgery, and Figure 4, 3-month result.','outcome':'A 28-year-old man with stable focal vitiligo, scarring and leukotrichia underwent follicular-unit extraction body-hair transplantation. The authors reported complete pigmentation at 12 weeks, partial reversal of leukotrichia and no recurrence at 3-month follow-up.','caution':'One patient and one selected patch. The after image also shows residual evidence of prior scarring and slight hyperpigmentation. This is not evidence of permanent cure or an outcome expected for generalized disease.'}, {'title':'Case B: Segmental vitiligo treated with scalp then pubic FUE grafts plus NB-UVB','before':'seg_before.jpg','after':'seg_after.jpg','citation':'Pillai J, Goyal N. Repigmentation of Segmental Vitiligo with Scalp and Pubic Follicular Unit Extraction Graft Transplantation. Int J Trichology. 2023;15:70-73. PMID: 37701552. PMCID: PMC10495070.','source':'Figure 1, baseline left chest/inframammary patch, and Figure 6, 7 months after the second transplant.','outcome':'The report describes segmental vitiligo treated with two staged follicular-unit extraction procedures plus NB-UVB photostimulation. The authors reported complete repigmentation of the treated area 7 months after the second transplant.','caution':'Single case. The treatment involved surgery, staged grafting and photostimulation. The patient had persistent thick scalp hairs in some treated chest areas, a procedure-specific cosmetic trade-off.'}, {'title':'Case C: Extensive post-transplant vitiligo treated with melanocyte-keratinocyte transplantation','before':'mkt_face.jpg','after':'mkt_neck.jpg','citation':'Tang H, Wang C, Fu L, Xu A-E. Successful Repigmentation of Vitiligo after Allogeneic Bone Marrow Transplantation for Hodgkin’s Lymphoma by Autologous Noncultured Melanocyte-Keratinocyte Transplantation. Indian J Dermatol. 2015;60:470. PMID: 26538694. PMCID: PMC4601414.','source':'Figure 3 documents facial results at 8 months after staged transplantation; Figure 4 documents neck lesion before surgery and near-complete result after surgery.','outcome':'An 18-year-old patient with vitiligo after allogeneic bone marrow transplantation underwent four non-cultured melanocyte-keratinocyte transplant procedures after poor response to conservative care. Reported outcomes included 100% repigmentation at 8 months in one facial area, 98% in a second facial area, and 95% to nearly 100% in neck areas.','caution':'This is an unusual post-bone-marrow-transplant context, not a standard generalized-vitiligo cohort. The published composite figures show treated sites at different timings; they should not be interpreted as a single whole-body before/after pair.'}, {'title':'Supportive visual series: Follicular vitiligo treated by a two-step hair procedure','before':'follicular_beforeafter.jpg','after':'follicular_vertex.jpg','citation':'Minimally Invasive Removal of Leukotrichia and Hair Transplantation: A 2-Step Surgery in the Treatment of Stable Follicular Vitiligo. Plast Reconstr Surg Glob Open. 2024. PMCID: PMC11412555.','source':'Figure 2, forehead lesion before treatment, procedure and 1-year result; Figure 4, vertex lesion before treatment and 3-month repigmentation.','outcome':'This open-access series provides clearly labeled visual before/after examples of follicular vitiligo with leukotrichia following a combined surgical approach. It supports the visual plausibility of follicular repigmentation but was not selected as a “complete cure” report.','caution':'Useful photographic support, but does not substitute for controlled evidence. Exact outcomes, techniques and patient selection must be read in the primary report.'} ] styles=getSampleStyleSheet() styles.add(ParagraphStyle(name='Title2',parent=styles['Title'],fontName='Helvetica-Bold',fontSize=21,leading=25,textColor=colors.HexColor('#1F4E79'),alignment=TA_CENTER,spaceAfter=14)) styles.add(ParagraphStyle(name='H1x',parent=styles['Heading1'],fontName='Helvetica-Bold',fontSize=15,leading=18,textColor=colors.HexColor('#1F4E79'),spaceBefore=8,spaceAfter=8)) styles.add(ParagraphStyle(name='H2x',parent=styles['Heading2'],fontName='Helvetica-Bold',fontSize=12,leading=15,textColor=colors.HexColor('#1F4E79'),spaceBefore=8,spaceAfter=5)) styles.add(ParagraphStyle(name='Bodyx',parent=styles['BodyText'],fontName='Helvetica',fontSize=9.3,leading=13,spaceAfter=7)) styles.add(ParagraphStyle(name='Smallx',parent=styles['BodyText'],fontName='Helvetica',fontSize=7.5,leading=10,textColor=colors.HexColor('#4D4D4D'),spaceAfter=5)) styles.add(ParagraphStyle(name='Callout',parent=styles['BodyText'],fontName='Helvetica-Bold',fontSize=9.5,leading=13,backColor=colors.HexColor('#EAF2F8'),borderColor=colors.HexColor('#9ECAE1'),borderWidth=.6,borderPadding=7,spaceAfter=10)) def page_num(canvas,doc): canvas.saveState(); canvas.setFont('Helvetica',7.5); canvas.setFillColor(colors.HexColor('#555555')) canvas.drawString(1.5*cm,1.05*cm,'Illustrated evidence report | 27 September 2026') canvas.drawRightString(A4[0]-1.5*cm,1.05*cm,f'Page {doc.page}') canvas.restoreState() def P(text,sty='Bodyx'):return Paragraph(text,styles[sty]) def im(path,maxw=8.1*cm,maxh=9*cm): x=Image.open(path); w,h=x.size; sc=min(maxw/w,maxh/h); return RLImage(str(path),width=w*sc,height=h*sc) def photo_pair(before,after): a=im(AS/before); b=im(AS/after) data=[[P('<b>Before / baseline</b>','Smallx'),P('<b>After / follow-up</b>','Smallx')],[a,b]] t=Table(data,colWidths=[8.3*cm,8.3*cm],hAlign='CENTER') t.setStyle(TableStyle([('VALIGN',(0,0),(-1,-1),'TOP'),('ALIGN',(0,0),(-1,-1),'CENTER'),('LINEBELOW',(0,0),(-1,0),.4,colors.HexColor('#7F8C8D')),('BOTTOMPADDING',(0,0),(-1,0),4),('TOPPADDING',(0,1),(-1,-1),6)])) return t story=[] story += [Spacer(1,2.3*cm),P('Published Evidence of Complete or Near-Complete Repigmentation in Vitiligo','Title2'),P('Illustrated evidence report with publication-source clinical photographs','H2x'),Spacer(1,.5*cm),P('<b>Prepared:</b> 27 September 2026<br/><b>Scope:</b> Documented complete, 100%, or near-complete repigmentation outcomes. Photographs are reproduced from identified open-access PubMed Central articles solely for evidence illustration and are individually attributed.','Bodyx'),Spacer(1,.4*cm),P('Key conclusion: complete or 100% repigmentation can be documented in selected treated lesions, most often in stable localized or segmental vitiligo treated with surgery. This is not synonymous with a permanent cure of vitiligo.','Callout'),Spacer(1,1.2*cm),P('Contents','H1x'),P('1. Scope and interpretation<br/>2. Photo evidence cases<br/>3. Comparative evidence table<br/>4. What the literature does and does not show<br/>5. References and image-use notes','Bodyx'),PageBreak()] story += [P('1. Scope and interpretation','H1x'),P('Vitiligo is a chronic immune-mediated depigmenting condition. In this report, <b>complete repigmentation</b> means that an article author explicitly described a treated lesion as completely or 100% repigmented. It does not mean that all vitiligo in the person was permanently eliminated, nor does it imply the same result can be expected in another patient.','Bodyx'),P('The illustrated reports were selected because their clinical figures and figure captions are available in open-access PubMed Central articles and their textual outcomes could be checked against the primary report. Images are publication figures, not stock photographs and not computer-generated examples.','Bodyx'),P('<b>Important limitation:</b> Before/after photography can be influenced by lighting, camera angle, skin tone, interval duration and assessment method. It is supportive evidence, not a substitute for trial-level comparative data.','Callout'),P('Why surgery appears repeatedly in the photo evidence','H2x'),P('Surgical approaches transfer melanocytes or hair follicles containing melanocyte reservoirs into stable lesions. They are generally considered only when disease is stable and the lesion is suitable. They are invasive, technically dependent, and may have scarring, colour mismatch, cobblestoning, unwanted hair growth, infection or disease-reactivation risks.','Bodyx'),P('Textbook context','H2x'),P('Dermatology 2-Volume Set, 5th edition, reports that total repigmentation is only rarely achieved because response differs by body area, and approximately 30% of patients may not respond despite months of therapy. <i>Dermatology 2-Volume Set, 5th ed., “Treatment protocols and results,” lines 3469-3470.</i>','Smallx'),PageBreak()] for idx,c in enumerate(cases,1): story += [P(f'2.{idx} {c["title"]}','H1x'),photo_pair(c['before'],c['after']),Spacer(1,.12*cm),P(f'<b>Figure source:</b> {c["source"]}','Smallx'),P(f'<b>Reported result:</b> {c["outcome"]}','Bodyx'),P(f'<b>How to interpret it:</b> {c["caution"]}','Callout'),P(f'<b>Primary source:</b> {c["citation"]}','Smallx'),PageBreak()] story += [P('3. Comparative evidence summary','H1x')] data=[[P('<b>Evidence</b>','Smallx'),P('<b>Design / population</b>','Smallx'),P('<b>Outcome relevant to recovery</b>','Smallx'),P('<b>Interpretation</b>','Smallx')], [P('Malakar & Dhar, 1999<br/>PMID 10325459','Smallx'),P('Prospective series; 1,000 stable/recalcitrant patients screened; 880 test-graft-positive patients analyzed.','Smallx'),P('656/880 (74.55%) achieved 90-100% repigmentation after autologous miniature punch grafting.','Smallx'),P('Large series but nonrandomized and enriched by test-graft positivity. Polka-dot appearance 43.98%; colour mismatch 34.32%.','Smallx')], [P('van Geel et al., 2004<br/>PMID 15492182','Smallx'),P('Randomized double-blind placebo-controlled lesion-pair trial; 28 patients, 33 lesions.','Smallx'),P('In stable disease, at least 70% repigmentation in 77% of grafted lesions by 12 months.','Smallx'),P('Supports selection for disease stability. Does not claim universal 100% clearance.','Smallx')], [P('Orouji et al., 2018<br/>PMID 29103774','Smallx'),P('Open-label clinical trial; 300 people, 1,060 stable patches; autologous epidermal cells.','Smallx'),P('More than 50% repigmentation in 32.2% of patches at 9 months; 79.3% of achieved repigmentation stable during follow-up to 30 months.','Smallx'),P('Complete-response counts not reported. Face, neck and trunk did better.','Smallx')], [P('Jafarzadeh et al., 2025<br/>PMID 39509558','Smallx'),P('Systematic review; 48 articles, 2,186 participants; regenerative treatments.','Smallx'),P('Meaningful repigmentation reported for non-cultured melanocyte-keratinocyte and hair follicle techniques.','Smallx'),P('Heterogeneity and risk of bias: 48.84% of included studies had high overall risk of bias.','Smallx')], [P('Xireaili et al., 2026<br/>PMID 41804555','Smallx'),P('Systematic review/meta-analysis; 18 studies, 1,341 participants; home versus office UVB.','Smallx'),P('Home UVB noninferior to office UVB for >50% and >75% repigmentation.','Smallx'),P('Does not establish complete cure.','Smallx')]] t=Table(data,colWidths=[3.25*cm,4.2*cm,5.0*cm,4.2*cm],repeatRows=1) t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,0),colors.HexColor('#1F4E79')),('TEXTCOLOR',(0,0),(-1,0),colors.white),('GRID',(0,0),(-1,-1),.35,colors.HexColor('#9EADBA')),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),4),('RIGHTPADDING',(0,0),(-1,-1),4),('TOPPADDING',(0,0),(-1,-1),4),('BOTTOMPADDING',(0,0),(-1,-1),4),('ROWBACKGROUNDS',(0,1),(-1,-1),[colors.white,colors.HexColor('#F4F8FB')])])) story += [t,Spacer(1,.3*cm),P('Evidence hierarchy: case reports are low-certainty, hypothesis-generating evidence. Randomized trials and systematic reviews provide stronger estimates of average effects but may not directly answer whether a particular person will have complete repigmentation.','Callout'),PageBreak(),P('4. Conclusions for use of this report','H1x'),P('<b>Supported by the literature:</b> Individual treated patches can achieve complete or near-complete repigmentation. Such results are most consistently documented in selected stable lesions treated with surgical transfer of melanocytes or hair follicles. Phototherapy and topical treatments can provide meaningful repigmentation, often measured at >50% or >75% thresholds.','Bodyx'),P('<b>Not supported:</b> A claim that vitiligo has a universally available permanent cure. The image reports are not proof that a procedure is suitable for active, widespread, acral, or mucosal vitiligo, or for a person with relevant comorbidities.','Bodyx'),P('<b>Clinical safety:</b> Decisions regarding phototherapy, surgery, systemic corticosteroids, oral JAK inhibitors, or off-label procedures require a dermatologist. JAK inhibitors and systemic treatment can have material contraindications and monitoring requirements.','Callout'),P('5. References','H1x')] refs=[c['citation'] for c in cases]+['Malakar S, Dhar S. Treatment of stable and recalcitrant vitiligo by autologous miniature punch grafting: a prospective study of 1,000 patients. Dermatology. 1999. PMID: 10325459.','van Geel N, et al. Double-blind placebo-controlled study of autologous transplanted epidermal cell suspensions for repigmenting vitiligo. Arch Dermatol. 2004. PMID: 15492182.','Orouji Z, et al. A single-arm open-label clinical trial of autologous epidermal cell transplantation for stable vitiligo: a 30-month follow-up. J Dermatol Sci. 2018. PMID: 29103774.','Jafarzadeh A, et al. A systematic review of case series and clinical trials investigating regenerative medicine for the treatment of vitiligo. J Cosmet Dermatol. 2025. PMID: 39509558.','Xireaili F, et al. The effectiveness of home-based phototherapy in vitiligo: a systematic review and meta-analysis. Photodermatol Photoimmunol Photomed. 2026. PMID: 41804555.'] for n,x in enumerate(refs,1):story.append(P(f'{n}. {x}','Smallx')) story += [Spacer(1,.2*cm),P('Image use and attribution','H2x'),P('All clinical photographs used here were downloaded from the specific PubMed Central open-access article cited in each case section. They remain subject to the respective article’s copyright/licence terms. They are included as source-attributed evidence illustrations for research/educational review, not for commercial reuse. The report does not modify clinical images beyond layout scaling.','Smallx')] doc=SimpleDocTemplate(str(PDF),pagesize=A4,rightMargin=1.5*cm,leftMargin=1.5*cm,topMargin=1.4*cm,bottomMargin=1.6*cm,title='Vitiligo Complete Repigmentation Illustrated Evidence Report',author='Orris') doc.build(story,onFirstPage=page_num,onLaterPages=page_num) # Revised Word document: retain original content and append a source-attributed photo appendix wd=Document(str(orig)) wd.add_page_break(); wd.add_heading('Illustrated Appendix: Publication-Source Before-and-After Evidence',0) p=wd.add_paragraph('These figures are clinical photographs from the identified open-access PubMed Central primary reports. Each image is individually source-attributed. They document outcomes in selected individual cases and do not establish a permanent cure or a guaranteed response.') p.runs[0].bold=True for c in cases: wd.add_heading(c['title'],1) tbl=wd.add_table(rows=2,cols=2); tbl.style='Table Grid' tbl.cell(0,0).text='Before / baseline';tbl.cell(0,1).text='After / follow-up' for cell in tbl.rows[0].cells: for run in cell.paragraphs[0].runs: run.bold=True for cell,f in zip(tbl.rows[1].cells,[c['before'],c['after']]): cell.paragraphs[0].alignment=WD_ALIGN_PARAGRAPH.CENTER; cell.paragraphs[0].add_run().add_picture(str(AS/f),width=Inches(3.05)) p=wd.add_paragraph(); p.add_run('Figure source: ').bold=True;p.add_run(c['source']) p=wd.add_paragraph(); p.add_run('Reported result: ').bold=True;p.add_run(c['outcome']) p=wd.add_paragraph(); p.add_run('Caution: ').bold=True;p.add_run(c['caution']) p=wd.add_paragraph(); p.add_run('Primary source: ').bold=True;p.add_run(c['citation']) wd.save(str(DOCX)) print(PDF);print(DOCX) ''') PY python3 "/tmp/workspace/vitiligo-complete-repigmentation/src/build_illustrated_reports.py" ls -lh "/tmp/workspace/vitiligo-complete-repigmentation/output"

python3 - <<'PY' from pypdf import PdfReader from docx import Document from pathlib import Path root=Path('/tmp/workspace/vitiligo-complete-repigmentation/output') pdf=root/'Vitiligo_Complete_Repigmentation_Illustrated_Evidence_Report.pdf' r=PdfReader(str(pdf)); text='\n'.join(p.extract_text() or '' for p in r.pages) print('PDF pages',len(r.pages),'bytes',pdf.stat().st_size) for term in ['Body-hair follicular-unit transplantation','complete pigmentation at 12 weeks','Image use and attribution','complete or 100% repigmentation']: print(term,term in text) docx=root/'Vitiligo_Complete_Repigmentation_Evidence_Compilation_Illustrated.docx'; d=Document(str(docx)) print('DOCX paragraphs',len(d.paragraphs),'tables',len(d.tables),'inline_images',len(d.inline_shapes),'bytes',docx.stat().st_size) print('appendix',any('Illustrated Appendix' in p.text for p in d.paragraphs)) PY

vitiligo AND guideline

vitiligo AND treatment

vitiligo clinical photos generalized segmental and acrofacial vitiligo Wood lamp examination

vitiligo histopathology melanocyte loss immunohistochemistry diagram

vitiligo international guideline diagnosis management 2025 official PDF

PMID: 42219812

PMID: 38477910

PMID: 39509558

https://pmc.ncbi.nlm.nih.gov/articles/PMC13435076/