
 nevus depigmentosus is a hypomelanotic condition which is usually refractory to medical modalities of treatment.a few cases of surgical repigmentation have been reported.one case report from south korea described the recurrence of hypomelanosis at the surgically treated site after eight years . 
 
nevus depigmentosus is a hypomelanotic condition which is usually refractory to medical modalities of treatment .
one case report from south korea described the recurrence of hypomelanosis at the surgically treated site after eight years .
nevus depigmentosus ( nd ) is a rare , congenital , stable hypomelanosis first described by lesser in 1884 .
the lesions usually present as dermatomal or quasidermatomal macules commonly on the trunk , lower abdomen , or proximal extremities .
they are off - white in colour and have irregular , serrated , feathered , or geographic margins .
the face , when involved , is a cause of social embarrassment for the patient . unfortunately , there is no effective treatment for this condition .
here we report a patient of nd treated successfully with suction blister grafting , in whom the pigment has been well maintained even after 10 years .
a 15-year - old female student presented with a hypopigmented asymptomatic macule on the left half of the upper lip [ figure 1 ] slightly extending to the left cheek , since birth .
examination of other areas of the skin did not reveal any similar lesions or any other type of skin lesions and the other systems particularly the skeletal and nervous system were within normal limits .
her investigation revealed normal blood counts ; liver function test ( lft ) , renal function test ( rft ) , clotting profile , and test for hiv were negative .
nevus depigmentosus distributed on the left half of the upper lip with extension to the chin in march 2002 , suction blister grafting was performed on her after taking informed consent .
multiple blisters were raised on the left thigh using a suction blister technique described by gupta et al .
then , the blister roof from the thigh was removed with the help of iris scissors , transferred on to a glass slide ; the edges were trimmed to fit the shape of the recipient area and then applied on to the recipient nd site [ figure 2 ] . when the dressing was removed after 48 hours
the patient was put on topical puvasol ( psoralen plus ultraviolet - a of solar origin ) after the grafts fell off and the resultant pigmentation was satisfactory at a follow - up after 1 month .
application of suction blister grafts at the recipient site the patient followed up in the clinic after a gap of 10 years in may 2012 , and on examination , it was found that the pigmentation achieved with suction blister grafting was well maintained [ figure 3 ] , though there were a few areas of patchy hyperpigmentation toward the angle of the lip on the left side .
the disease is primarily limited to the skin though there are reports of association of neurological abnormalities and limb hypertrophy the commonly used clinical diagnostic criteria for nd are as follows : 
 leukoderma present at birth or of an early onsetno alteration in the distribution of leukoderma throughout lifeno alteration in texture or change in sensation in the affected areaabsence of hyperpigmented border 
  leukoderma present at birth or of an early onset no alteration in the distribution of leukoderma throughout life no alteration in texture or change in sensation in the affected area absence of hyperpigmented border lee et al . found that the majority ( 92.5% ) of nd present before the age of three years and have serrated irregular borders ( 77.4% ) .
wood 's lamp examination shows an off - white accentuation in nd as compared to the chalky white accentuation in the case of vitiligo .
described the procedure of suction blister grafting as helpful in nd but the follow - up details in that case were not known .
kim et al . reported a case of recurrence of nd eight years after autologous epidermal grafting where he considered the newly developed hypopigmented macules to be a functional impairment of melanocytes in nd . in the present case ,
the follow - up was after 10 years and the pigment gained after suction blister grafting was stable .
the epidermal sheets used for grafting in nd should completely cover the area of nd for a uniform repigmentation .
in contrast , there have been reports of poor quality of repigmentation with cell suspension or melanocyte keratinocyte transplantation .
as the resultant cosmetic discomfort for facial lesions of nd can be embarrassing to the patient and no effective therapeutic options are available , surgical repigmentation with blister grafting should be offered to all interested patients .
pigmentation was well maintained at the site of suction blister grafting after 10 years , and hence , suction blister grafting should be offered to all willing patients .
 nevus depigmentosus is a congenital hypomelanotic condition for which no effective treatments are available . 
 the hypopigmentation is permanent and enlarges in proportion with growth in the person . here 
 , i report a patient of nevus depigmentosus on whom we performed suction blister grafting and the resultant pigmentation was satisfactory even at a follow - up after 10 years . 
Introduction
Case Report
Discussion