Vitiligo is a common disease that causes skin discoloration due to the destruction of melanocytes, with a current global prevalence of 0.5% to 1%, and often has a negative psychosocial impact on patients. Current treatments include topical glucocorticoids, immunomodulators, and phototherapy, however, these treatments are usually of long duration and are not tolerated by many patients. Surgical approaches are used to treat intractable vitiligo and include drill hole grafts, negative pressure blistering autologous epidermal grafts, bladed thick skin grafts, non-cultured epidermal cell suspension grafts, and cultured melanocyte grafts. Negative pressure blistering autologous epidermal grafting is an efficacious treatment modality that was first reported by Falabella in 1971. A meta-analysis showed an effectiveness rate of 87% and over 75% pigmentation regain. Although negative pressure blistering autologous epidermal grafts are considered safe and effective, there is no uniform understanding of the predictors of pigmentation expansion and survival of the grafted skin fragments. Professor Gou, from the United States, evaluated the impact of patient baseline conditions such as age, gender, and site of disease on overall graft survival and pigmentation expansion by comparing pre- and post-transplant photographs, which were published in the May 2015 issue of Dermatologic Surgery. The retrospective study included all patients diagnosed with vitiligo and treated with negative pressure blistering autologous epidermal grafts admitted to The University of Texas Southwestern Medical Center between 2008 and 2014. Follow-up was for at least 1 month to count graft survival. To ensure sufficient time for pigmentation of the grafted skin fragments to expand, only patients who had been followed up for more than 3 months were evaluated for the degree of hyperpigmentation. The grafting procedure is as follows: (1) Local infiltration anesthesia is applied to the recipient area and the donor area respectively, with the donor area usually selected as an uninfected, hidden area (buttocks, lower abdomen and thighs). (2) Negative pressure suction is applied to the donor and recipient areas using a 5 ml syringe with a pressure control of 30-40 mmHg, where the syringe is connected to the suction device. The blister formation was accelerated by baking lamp irradiation and the skin surface temperature was maintained at 40°C. (3) Blister formation after 1-3 hours (see Figure 1). Thicker skin areas, such as hands, feet, knees and elbows take longer to blister. (4) Cut away the blistering skin of the recipient area. Similarly, remove the blistering skin from the donor area, cover the defective area in the recipient area, and spread the skin piece flat. (5) The graft site is covered with petroleum jelly gauze and fixed with a bandage. (6) Keep the recipient area dry and remove the bandage after 7 days. A total of 28 patients were included in the study. The total number of skin grafts was 129, of which 86.8% (112/129) survived. Graft survival was highest in patients less than 20 years of age (100%) and lowest in patients older than 40 years (75%-78%) (see Figure 2). repigmentation was observed in 68% of patients. The highest degree of pigmentation extension was observed in the neck (283%) and face (231%), while the lowest was observed in the hands and feet (119%). The results showed that negative pressure blistering autologous epidermal grafts were safe and effective, with few complications and no cases of infection, postoperative bleeding or scar formation. Painful anesthesia and hyperpigmentation of the donor area were the most common adverse effects. Although all patients had hyperpigmented annular spots of 1-1.5 cm in size at the donor site, they faded over time. Figure 4 shows a before and after comparison of vitiligo lesions transplanted at one trunk site. However, this study still has the following shortcomings: retrospective study, small sample size and lack of control group, which will be improved in future studies from the above three points. Also, considering the influence of psychological factors on the analysis results, patient satisfaction scores on the efficacy should be included. In conclusion, negative pressure blistering autologous epidermal transplantation is an effective treatment for vitiligo, which is particularly effective in young patients with vitiligo on the face and neck.