Vitiligo evidence-based expert consensus recommendations for paediatric and adolescent patients: part I—topical therapeutics

Abstract

Abstract No United States paradigm for the treatment of paediatric, adolescent and young adult vitiligo has been developed. To develop evidence and consensus-based expert opinion to promote therapeutic consistency for the diagnosis and treatment of vitiligo. An IRB-exempted process was developed to produce consensus recommendations based on literature review and SORT criteria. Research questions were reviewed on 9 May 2022 in a video-based conference. Forty-two recommendations were made on the diagnosis of vitiligo (5) and optimal topical therapeutics (37). Topical calcineurin inhibitors, topical corticosteroids and topical ruxolitinib 1·5% cream were all identified as potential first-line therapies in the management of paediatric and adolescent patients with specific guidance on age-based data, frequency of application, minimum length of the therapeutic trial and coordinated usage of ultraviolet light therapy. The literature on paediatric and adolescent vitiligo has a heterogeneous methodology and lack of patient-reported outcomes. Children with vitiligo may be effectively managed with a variety of topical agents as first- and second-line therapy. Evidence supports the utility of topical calcineurin inhibitors, topical corticosteroids and topical JAK inhibitors, with limitations based on factors such as location, body surface area and age.