Childhood Vitiligo Research Articles

Prognostic factors in childhood vitiligo.

Vitiligo is a multifactorial disease characterized by the progressive loss of melanocytes. The worldwide prevalence ranges from 0.5% to 2%, and in children from 0% to 2.16%. The objective of this study was to determine the variables associated with progression of vitiligo. A retrospective cohort was carried out where a random sample of records of pediatric patients with vitiligo from January 2016 to December 2020 was analyzed. The variables were studied: age at onset, sex, hereditary family history, personal history of thyroid diseases, time of evolution, classification, Köebner phenomena, mucosal vitiligo, halo nevus, premature graying and the presence of other dermatoses. The final state was classified as progression, stability, partial remission and complete remission. 574 children with vitiligo; 290 (50.5%) women, 284 (49.5%) men. Non-segmental vitiligo in 324 (56.4%), segmental vitiligo in 250 (43.6%). Mean age of onset 8.7 years (SD: 4.54). Median evolution time 6 months (25th percentile of 3 months and 75th percentile of 24 months). Family history 27 (4.70%). Thyroid disease 7 (1.21%). Evolution remained stable in 44 (7.7%), 68 (11.8%) had progression, 32 (5.6%) complete remission, 222 (38.7%) partial remission and 208 (36.2%) one consultation. Non-segmental vitiligo was obtained p < 0.028, younger age of onset p < 0.000, and none skin comorbidities p < 0.009. The variables that were associated with a more progression were non-segmental vitiligo, early ages at the onset of the disease, and not presenting with other skin diseases.

Epidemiologic and clinical differences between early-onset and later-onset childhood vitiligo: A retrospective cohort study

Epidemiologic and clinical differences between early-onset and later-onset childhood vitiligo: A retrospective cohort study

567 - Prognostic factors in pediatric patients with vitiligo

Abstract Introduction Vitiligo is a pigmentary disorder, and its prevalence reaches 2.16% in children.(1) Childhood vitiligo differs from adult vitiligo in clinical characteristics such as higher incidence in females, higher prevalence of segmental presentation and lower association with autoimmune disorders. (2) The course of vitiligo is unpredictable, the disease may regress, stabilize, progress and exacerbate. (3) Few studies of the course of vitiligo have been published. Objectives The aim of this study was to identify the clinical characteristics associated with the progression of vitiligo in children and adolescents and also to describe the epidemiological profile in our patients. Methods We analyzed the clinical records of a cohort of pediatric patients with vitiligo attended at Centro Dermatológico Dr. Ladislao de la Pascua in Mexico City. Vitiligo diagnosis was defined clinically and to classify patients with NSV we used the revised classification of the Vitiligo Global Issues Consensus Conference. The outcome was the progression of vitiligo, and it was defined as an increase in the extent of the disease at the last visit of follow-up of the patient. We extracted the following data: age at onset, presence of halo nevus, Koebner phenomenon, familial medical history of vitiligo, presence of autoimmune and thyroid disorders. The Koebner phenomenon was considered if lesions were present in areas of friction or if the parents reported their occurrence at sites of previous trauma. Statistical analysis was performed using software SPSS v.25. To calculate the follow-up time we calculate the number of days between the last visit to the first visit of the participant to the center. We define four states according to the clinical course of vitiligo: stable, partial remission, complete remission and progressión. Stable means that the affected body surface area (BSA) did not change over the time, partial remission that the BSA decreased, complete remission means a BSA equal to zero and progression an increase in the involved BSA. We made a survival analysis using Kaplan Meier curves. Results Of the 679 participants, 50.2% (341) were males and 49.8% (338) females, giving a male-to-female ratio of 1:1. The average age of onset was 8.6 years (SD 4.4 years). Non-segmental vitiligo (NSV) was more common (55.5%) than segmental vitiligo (44.5). Koebner’s phenomenon was observed in 22.5% of patients and halo nevus was diagnosed in 5% of them. Only 4.1% (28) of the patients had family history of vitiligo; 0.9% had thyroid disorders and 0.3% had been diagnosed with an autoimmune disorder. The mean time of follow up was 11 months. The clinical course of the patients was: stable 44.3%, partial remission 38.7%, complete remission 4.9% and progression in 12.1%. The median time to progression of vitiligo was 71 months equivalent to 5.9 years (95%CI 58.72-83.29 months). The mean time to progression for non-segmental vitiligo was 54.94 months vs. 61.94 patients with segmental vitiligo (p=0.087). Time to progression was different in patients with another skin disease 68.37 months vs. 54.53 months (p=0.015). There were no differences in time to progression for the following variables: treatment, age of onset, gender, family history, Koebner phenomenon, halo nevus and autoimmune disorders. Conclusions In our population childhood vitiligo has a slow progression rate and a low prevalence of family history and Koebner's phenomenon compared to other Latin American populations. (4) The ratio of non-segmental to segmental vitiligo and female to male were lower than other countries. (5) Studies with longer follow-up periods are needed to assess progression in vitiligo.

Homeopathy adds colour to life and skin: Constitutional homeopathy in childhood vitiligo - a retrospective study

Homeopathy adds colour to life and skin: Constitutional homeopathy in childhood vitiligo - a retrospective study

First Cousin Marriages and the Risk of Childhood-Onset Vitiligo: Exploring the Genetic Background: A Cross-Sectional Study.

Vitiligo, a condition characterized by depigmented skin, has been observed to have a higher incidence in patients with a family history of the disease. This study investigates the relationship between parental consanguinity, family medical history, and the onset of childhood vitiligo, hypothesizing that genetic factors play a significant role. A cross-sectional study was conducted involving 382 people diagnosed with vitiligo in Saudi Arabia. The study assessed the prevalence of parental consanguinity and its correlation with the disease's onset, employing statistical analysis to evaluate the data collected through medical records and family history questionnaires. The findings reveal a significant association between parental consanguinity, particularly among first cousins, and the incidence of childhood-onset vitiligo. Additionally, a notable correlation was found between family medical history and the onset of the condition, with familial vitiligo being more prevalent in patients with adult-onset vitiligo. This study underscores the critical role of genetic predispositions in the development of childhood-onset vitiligo, highlighting the influence of parental consanguinity. The results advocate for increased awareness and screening in populations with high rates of consanguinity to facilitate early detection and management of vitiligo. Future research should focus on exploring the genetic mechanisms underlying this association to develop targeted interventions.

Clinico-epidemiology vitiligo profile in childhood at Mangusada General Hospital Badung

Introduction: Vitiligo is a depigmentation disorder characterized by well-demarcated white macules and patches on the skin. Vitiligo commonly occurs in children or young adults. Vitiligo can be classified into segmental, non-segmental and mixed type. Childhood vitiligo is often associated with many negative consequences, especially marked psychosocial and long-lasting effects on the self-esteem of the affected children. This study investigated characteristics and risk factors associated with vitiligo in childhood. Method: This was a retrospective descriptive study of patient aged 0-18 years old that was diagnosed with vitiligo derived from interview and medical records of Dermatovenereology Outpatient Clinic in Mangusada Hospital, Badung, Bali, from January to September 2023. This study included profiling data such as gender, the onset of vitiligo, clinical distribution, risk factors, and family history that suggested influencing the development of vitiligo. This study used a total sampling method, and 21 patients were participating. Results: Vitiligo in childhood was found in 11 patients female (52%) and 10 male (48%) patients in this study. A third of the patients were in elementary school, and only one (5,5%) was in preschool. The age of vitiligo patients was 13-15 (23,81%). The site of onset vitiligo was mostly in the face (21,42%), lower limb (17,85%), scalp, lumbar, and foot (10,71%). The distribution type focal distribution was predominant (38,09%), followed by segmental and generalized distribution (23,8%) and acrofacial (14,28%). Conclusions: Vitiligo was predominantly affected in a female patient. Idiopathic was the most common risk factor for vitiligo, and focal distribution was the most common type of lesion. Since vitiligo is a cosmetic skin problem and is not contagious or threatening the patient’s life, the available treatment is sufficient.

Study of the epidemiologic characteristics of childhood vitiligo in Egyptian children

Background Vitiligo during childhood is common. Pediatric vitiligo has a profound effect on the quality of life of both children and their parents. Aims and objectives To investigate the epidemiologic characteristics of vitiligo among Egyptian children. Patients and methods A cross-sectional study was conducted and included children of both sexes from birth to less than 18 years of age. The study included schools and maternity and childhood care centers in Sohag Governorate, Upper Egypt, during the period from March 2019 to February 2020. Complete demographic and clinical information of children with vitiligo were recorded. Dermatological examination of patients with vitiligo was done. Vitiligo area and severity index of patients was calculated. Results Of 2594 screened children, 18 (0.7%) had vitiligo. The median age of children with vitiligo was 12 (2–17) years. The age interval from 13 to less than 18 years accounted for 44.4% of vitiligo cases. Females cases of vitiligo were more prevalent (61.1%). Overall, 72.2% of patients with vitiligo were resident of rural areas. Of the 18 cases with childhood vitiligo, 83.3% of cases had a history of consanguineous marriage and 66.5% had vitiligo vulgaris. A proportion of cases related the exacerbation of the disease to exposure to psychological stress. Conclusions Childhood vitiligo was detected in 0.7% of pediatric population in Upper Egypt. The majority of cases with childhood vitiligo had a history a consanguineous marriage between the parents. Psychic trauma was identified as a potential exacerbating factor of childhood vitiligo.

Childhood vitiligo developing after COVID-19 infection.

Both COVID-19 and vaccinations against it have been related to immune cutaneous manifestations. Here, we present a case of childhood vitiligo, developed after a COVID-19 infection.

Childhood vitiligo: A hospital-based cross-sectional study from South India

Background: Vitiligo, a depigmenting disorder results due to destruction of melanocytes in the affected skin. It may have psychosocial impact on children and their parents. Childhood vitiligo may differ from that in adults. Aim: To study the clinicoepidemiological profile and associated diseases in children with vitiligo. Methods: One hundred consecutive children (≤18 years) of both sexes, with vitiligo presenting between January and December 2018, were included. Detailed history, examination, and laboratory parameters were documented. Data were analyzed using simple statistical measures, chi-square, independent t tests, and Fisher exact test, wherever applicable. Results: Boys:girls ratio was 1:1.5. The mean age of onset was 9.17 ± 4.6 years [segmental vitiligo (SV: 6.6 ± 3.7 years) versus nonsegmental vitiligo (NSV: 9.7 ± 4.7 years); P = 0.014]. Vitiligo vulgaris (VV; 55, 55%) was the most common, followed by focal (16, 16%), segmental (16, 16%), and others. Most common site involved at onset (36, 36%) and presentation (n = 57) was lower limbs, but differed among various types. Leukotrichia was commonly seen in SV (n = 11, 68.8%) as compared to NSV [(n = 29, 34.5%); P = 0.01]. Family history (11, 11%) was seen only in NSV. Vitiligo disease activity score +4 was the most common (69, 69%). Koebner phenomenon was more common in NSV (n = 22, 26.2%) as compared to SV (n = 1, 6.3%) and varied among different types (P = 0.01). Nail changes were present in 72 children (72%); longitudinal ridging was the most common (n = 40, 55.6%). Thyroid function tests were abnormal in nine (11.7%) and 29 (36.3%) had anemia. Two had halo nevus. Conclusion: Various types of vitiligo in children seem to differ in their clinicoepidemiological characteristics, knowledge of which helps in better evaluation and management. Anemia and thyroid dysfunction seem to be common in children with vitiligo.

Evaluation of thyroid abnormalities in childhood vitiligo from a tertiary care centre: A case-control study

Vitiligo is an usual acquired pigmentary disorder of the skin characterized by well-circumscribed depigmented macules and patches. Though the association between vitiligo and thyroid disorders has been suggested, only a few studies from India and overseas have paid attention to describe the association between vitiligo and thyroid abnormalities, particularly in children. Hence, this study was taken up for evaluating thyroid disease in childhood vitiligo compared to controls in a tertiary care centre.This was a hospital-based case-control study conducted at a tertiary teaching hospital over 18 months which included 50 new patients of vitiligo and 50 age and sex-matched controls. Blood samples were garnered from cases and controls to access the levels of free triiodothyronine (fT3), free thyroxine (fT4), Thyroid-stimulating hormone ( TSH), anti-thyroid peroxidase (anti-TPO), and anti-thyroglobulin (anti –Tg).In our study, females outnumbered males in both groups. The frequencies of thyroid function and thyroid autoantibody abnormalities among vitiligo patients and control were 32% and 6%, respectively. The difference between case and controls for thyroid function abnormality was significant with a p-value of 0.001.Our study found a significant association betwixt thyroid disease and childhood vitiligo. Thus, evaluating vitiligo patients for thyroid abnormalities help to detect thyroid diseases or determine the possibility of eventual onset.

Global clinicoepidemiological pattern of childhood vitiligo: a systematic review and meta-analysis

BackgroundChildhood vitiligo differs from adult vitiligo in many aspects. To the best of the authors’ knowledge, there is no systematic review of different clinicoepidemiological patterns of vitiligo in children. This...

Tofacitinib 2% Gel in Childhood Vitiligo: Report of a Case of Significant Improvement.

Tofacitinib 2% Gel in Childhood Vitiligo: Report of a Case of Significant Improvement.

A 4-year follow-up study of 20 cases of stable localized childhood vitiligo treated by autologous, noncultured melanocyte–keratinocyte cell transplantation

Background: Vitiligo is a common skin disease affecting 1% to 2% of general population. Even though different modalities of treatment available, it remains as a difficult disease to treat. Many cases remain stable after a period of medical therapy without any further response. For treating pediatric vitiligo, currently available and result providing therapies are limited. Surgical techniques are the only hope in such patients. Only limited studies are available regarding surgical interventions in childhood vitiligo. Aim: To evaluate the response of autologous, noncultured melanocyte–keratinocyte cell transplantation in childhood stable vitiligo. Methods: A retrospective analysis was conducted in 20 cases of stable localized childhood vitiligo (10 segmental and 10 focal) treated by autologous, noncultured melanocyte–keratinocyte cell transplantation. Serial photographs were taken from the first visit onwards. The patients were followed for a period of 4 years. The results were analyzed on a visual analog scale. Results: Out of total 20 cases, 11 had excellent (90–100%) response, 4 had good (60–89%), 2 had fair (25–59%), and 3 had poor response (0–24%). Age and sex of the patients and size and duration of lesions did not show significant influence on results of transplantation. Conclusion: This is a simple, safe, and effective surgical therapy for replenishing the missing melanocytes even in resistant cases of vitiligo. Only limited studies are there in childhood vitiligo. In spite of its invasive nature, it can be used to treat localized stable vitiligo in children.

Clinico-epidemiological profile of childhood vitiligo: Experience from a tertiary care center of Northeast India

Background: Vitiligo is a common acquired skin disease characterized by depigmented macules and patches due to loss of functional melanocytes. Childhood-onset vitiligo has distinct epidemiological and clinical characteristics as compared to that of late-onset disease. Studies on childhood vitiligo are rare from the North-eastern part of the country. Aims and Objectives: The aim of the study was to study the clinical pattern of childhood vitiligo and its systemic association. Materials and Methods: All children up to 13 years presenting with childhood vitiligo were taken as study participants. A detailed history, general physical examination, cutaneous examination including hair, nail, genitalia, mucosae, and systemic examination to note down associated diseases was done. Relevant investigations were carried out whenever necessary. Eye and ear examination was performed for each patient. The findings were recorded in a pro forma for analysis and interpretation of data. Results: A total of 2544 pediatric patients attended the dermatology outpatient department during the study period, of which 52 cases had vitiligo. Thus, the occurrence of childhood vitiligo in the outpatient pediatric population was 2.04%. The most common age group at presentation was between 5 and 10 years (29; 55.77%). The most common initial site of involvement was head and neck (27; 51.92%). Vitiligo vulgaris was the most common type seen in 26 (50%) patients. A positive family history of vitiligo was obtained in 10 (19.23%) of the vitiligo patients. Seven (13.46%) childhood vitiligo patients were reported to have other associated diseases. Conclusion: Childhood vitiligo is a common entity in this part of the country. Most patients of childhood vitiligo have a limited body surface area involvement and therefore have to be treated accordingly; avoiding systemic treatments whenever not necessary. Autoimmune and cutaneous associations are rare in childhood vitiligo, though may develop later on, lest the disease progresses.

Quality of life assessment in childhood vitiligo in a tertiary care center in India.

The impact of vitiligo on quality of life (QOL) of children is not well studied. In this cross-sectional study, QOL in the form of Children's Dermatology Life Quality Index (CDLQI) was assessed in 114 children with vitiligo over a year. The mean CDLQI was 2.72 ± 3.35. There was a significant correlation of body surface area involved with the DLQI and the impairment was higher in older children. The psychosocial burden of vitiligo in children cannot be ignored and must be tackled early on in order to prevent an ever lasting impact on young minds.

Clinical efficacy analysis of 110 cases of childhood vitiligo with non-surgical combined therapy

Background Vitiligo has a negative effect on children’s physical and psychological health. Few studies have examined long-term treatment efficacy for childhood vitiligo. Therefore, we evaluated the long-term effectiveness of non-surgical combination therapy in pediatric patients with vitiligo and analyzed factors that affect its efficacy. Methods Pediatric patients (⩽12 years) with vitiligo who were treated with topical corticosteroids/topical calcineurin inhibitors and phototherapy for 12 months were retrospectively studied. Short-term systemic corticosteroids were administered according to individual clinical conditions. All lesions were photographed to assess repigmentation at 3-month intervals. Clinical data, the treatment effectiveness, and factors affecting the therapeutic effect were analyzed. Results Overall, 110 children (51 [53.6%] girls; mean [SD] age, 7.1 ± 3.0 years; 104 [94.5%] with activity status) were treated for a mean period of 23.13 ± 14.03 months (range, 5–86 months). The overall >50% repigmentation rate was 64.5%. A longer duration of treatment was associated with a higher repigmentation rate (X 2 trend = 36.229, P < .001). The vitiligo disease activity score at the first visit was positively correlated with the overall repigmentation rate (rs = 0.301, P = .001). Conclusions Treatment lasting longer than 1 year is recommended in children with vitiligo. The best repigmentation effect can be achieved by combination therapy in the rapid progression stage.

Treatment outcomes and prognostic factors of motorized 0.5-mm micropunch grafting with a skin-seeding technique for 83 cases of vitiligo in children

To the Editor: Childhood vitiligo is mostly of the segmental type, showing more stable progression and better responses to surgical treatments.1 However, the painful and time-consuming procedure of conventional skin grafting presents a major challenge for refractory childhood vitiligo. Recently, motorized micropunch grafting with skin-seeding technique (SST) was introduced,2,3 promising better compliance for children due to its easier and faster procedure with less pain. In this study, we evaluated the treatment outcomes and prognostic factors of the modality in childhood vitiligo.

Clinicoepidemiological Features of Childhood and Adult Vitiligo - A Cross- Sectional Observational Study

BACKGROUND&#x0D; Vitiligo is an acquired primary, usually progressive, melanocytopenia of unknown aetiology clinically manifested by circumscribed achromic macules and histologically by degeneration and disappearance of melanocytes in involved skin. Childhood vitiligo deserves special attention as it has unique epidemiological features. We wanted to determine, compare and analyze the clinical and epidemiological features and autoimmune disease associations in childhood vitiligo and adult vitiligo.&#x0D; METHODS&#x0D; It was a prospective cross-sectional observational hospital-based clinical study conducted in a suburban medical college hospital over 20 months which involved 120 patients with vitiligo who were assessed using detailed history and clinical examination for demographic and clinical data. Relevant history and family history were noted. Investigations including complete hemogram, serum biochemistry profile, thyroid profile and fasting plasma glucose examination were performed in all patients. Data were collected, tabulated, and all statistical analysis was done by using SPSS trial version 25 and in MS Excel 2007.&#x0D; RESULTS&#x0D; The majority of patients were in the age group of 16-30 years. Among 60 patients, female preponderance was noted in the study with a percentage of 53.3 % followed by 46 % males in the childhood group. The prevalence of segmental vitiligo was more in children (30 %) than in adults (5 %) which was statistically significant (P= 0.000). In adults, there was a statistically significant higher prevalence (P=0.000) of mucosal vitiligo (30 %) than in children (3.35 %). On performing statistical analysis, thyroid dysfunction (P=0.00) and diabetes mellitus (P=0.01) were found to be significantly more prevalent in adults than in children.&#x0D; CONCLUSIONS&#x0D; This study provides clinical evidence that vitiligo at different ages has different characteristics mainly regarding an increased incidence of segmental vitiligo and a more common positive family history among children than adults. A higher prevalence of thyroid dysfunction and diabetes mellitus in adult vitiligo patients compared to children warrants prompt treatment in all detected cases to prevent long-term morbidity and complications.

Epidemiological and clinical profile of childhood vitiligo in Abidjan

Background Vitiligo is an acquired and visible leucoderma that can lead to social stigmatization. The aim of this study was to establish the epidemiological and clinical profile of childhood vitiligo in Abidjan. In fact, very little data is available on this chronic child disease in sub-Saharan Africa, particularly in Côte d’Ivoire. Methods We carried out a cross-sectional study at University Teaching Hospital of Treichville from June 2017 to June 2018. All children under 16 years old with vitiligo who meet our selection criteria were included. CSPRO 7.2 and SPSS 23 software were used for data analysis and the significance threshold was set at 0.05. Results The prevalence of childhood vitiligo was 1.78%. Our series consisted of 19 boys and 21 girls (sex ratio M/F: 0.9). Children aged between 9 and 15 years old were the most affected (45%). The main family history were diabetes (37.5%), early canitis (30%) and vitiligo (17.5%). Atopic dermatitis was the main dermatosis associated with the childhood vitiligo (17.5%). The main clinical form of vitiligo was the non-segmental form (47.5%). The segmental and mixed forms had rates of 42.5% and 10% respectively. The vitiligo lesions were mainly located in sun-exposed areas (52.5%) and the segmental vitiligo significantly reached the face (P=0.04). Segmental vitiligo was also more common in children aged 0 to 3 years (P=0.03). The Koebner phenomenon was present in 5 children and was statistically associated with non-segmental vitiligo (P=0.04). Conclusion The prevalence of vitiligo in our series was 1.78%. This pathology occurs mainly in older children. The main clinical form was the non-segmental form. The affection was most often located on the sun-exposed areas.

Inverse association between autoimmunity and elevated IgE among childhood vitiligo.

Multiple factors contribute to the pathogenesis of childhood vitiligo. The characteristics in a different population under modified environmental factors need further reevaluation. The present study aimed to reevaluate the clinical and laboratory features in consequent children vitiligo patients. We retrospectively reviewed consequent children vitiligo patients who visited Children's Hospital of Fudan University (National Children's Medical Center of China). The prevalence rate of thyroid dysfunction, circulating autoantibodies, serum IgE, and associated factors were analyzed. A total of 244 consequent vitiligo patients were included, of which 20 children had personal autoimmune history. Two hundred and nineteen of the 244 patients took a thyroid function test, and the abnormal rate was only 3.7% (8/219). The elevated IgE rate was 31.7% (52/157), the antinuclear antibody (ANA) positive rate was 9.8% (12/123), and the extractable nuclear antigens (ENA) positive rate was 4.4% (4/91), respectively. The elevated IgE was significantly associated with atopic disease history and male gender. Of note, personal autoimmune history showed a significant inverse association with elevated IgE. Thyroid dysfunction rate was low among the consequent children vitiligo patients. Personal autoimmune history was inversely associated with elevated IgE. Various clinical characteristics and pathogenesis might contribute to different long-term outcomes of vitiligo.