Clinico-epidemiological profile of childhood vitiligo

Abstract

Background: Vitiligo is a depigmenting and psychologically devastating disorder. Childhood-onset vitiligo has different epidemiological and clinical characteristics as compared to adults. Aim: To study the clinical and epidemiological characteristics of childhood vitiligo. Materials and Methods: First 100 pediatric patients younger than 18 years, with vitiligo who attended the Pediatric Dermatology Clinic of Victoria Hospital, Bangalore Medical College, Bangalore, India, between April 2013 and December 2013 were included in the study. A detailed history and examination along with autoimmune diseases, laboratory parameters, and vitiligo disease activity score (VIDA) score were recorded. Results: In the 100 patients who attended pediatric dermatology OPD in 9 months duration of the study, we had 55 female patients (55%) and 45 male patients (45%). The mean age at onset was 8.92 years (ranging day 1-16 years), with duration of disease varying from 2 months to 8 years with mean duration of 1.36 years. According to standard classification most common pattern of vitiligo was vulgaris (46%), followed by focal (36%), mucosal (8%), acro-facial (7%), segmental (3%). The most common site for vitiligo was lower limb (62%), followed by face (46%), upper limbs (30%), scalp (25%), and mucosal (18%). Segmental vitiligo was seen in 3% and nonsegmental vitiligo in 97%. VIDA score +4 was most common and was seen in 81%. Conclusion: Vitiligo is a common depigmenting disorder with vulgaris being the most common pattern and lower limbs being the most common site seen in pediatric patients. Autoimmune associations were more frequent in nonsegmental vitiligo. Among the cutaneous associations, atopic dermatitis was most frequently encountered. Patients with family history of autoimmune disorders tend to present at an early age.