Current Management of Pediatric Vitiligo

Abstract

Vitiligo is a common inflammatory disorder with worldwide prevalence of 0.4-2 % of the population, with half of cases beginning in childhood. The management of childhood vitiligo should be tailored to avoid negative effects on the overall growth and psychological development of the patient. Therapy of vitiligo in childhood is chosen based on the location of the lesions, lesion age, and extent of lesions in the context of the child's age and the developmental status of the child. There are four age categories in childhood vitiligo: [1] infantile and toddler (rare) (ages 0-3 years), [2] ages 4-8 years, [3] ages 9-12 years, and [4] 13+ years of age, based on developmental stage, psychological maturation, and ability to comply or participate in therapy. These categories are also differentiated psychologically by susceptibility to bullying, self-image development, and personal concern with lesion appearance, which increases with time. Intervention is advisable in cases with facial and leg involvement due to prominence of lesions and cosmetic defect. Medical interventions are largely the usage of topical therapies including corticosteroids and calcineurin inhibitors, some vitamin therapy (oral and topical vitamin D), and judicious introduction of phototherapy sources based on age and severity. Screening and appropriate subspecialist referral for co-morbidities (e.g., thyroid disease, celiac disease, psychological distress, and vitamin D deficiency) may enhance overall health. Cosmesis and camouflage are generally safe in childhood and have been noted to improve overall quality of life in this grouping. Genetic transmission of vitiligo is minimal at 5-6 % in first-degree relatives. This article reviews the therapeutics of pediatric vitiligo from the perspective of developmental stages and response to therapy.

A prospective study of vitiligo cases in Government Dharmapuri Medical College Hospital

“…5 Vitiligo can be associated with other autoimmune disorders like Diabetes mellitus, hash moto's thyroiditis, alopecia areata, SLE etc. 6,7 In our study we have evaluated for associated systemic illness which showed 8% of patient had diabetes mellitus, where similar results is seen in a study by Dauber et al One patient had hypothyroidism and one had hyperthyroidism when compared to 7 % cases were associated with graves diseases in a study. 8 Altar et al in a study on 192 vitiligo patients in the age group 6-60 years found that generalised type of vitiligo was present in 72.9%.…”

Tacalcitol: a useful adjunct to narrow‐band ultraviolet‐B phototherapy in vitiligo

“…Topical tacalcitol potentiates efficacy of NBUVB as it enhances extent of pigmentation, decrease time to repigmentation and lowers the cumulative doses of NBUVB, thereby leading to greater patient satisfaction and improved compliance. Vitiligo is an acquired depigmenting disorder, generally affecting 0.4-2% of the worldwide population (1). There is no definite cure for vitiligo, thus making the treatment a tough challenge for the dermatologists.…”

“…Vitiligo is an acquired depigmenting disorder, generally affecting 0.4–2% of the worldwide population . There is no definite cure for vitiligo, thus making the treatment a tough challenge for the dermatologists.…”

Clinical and Demographic Characteristics of Children with Vitiligo: Retrospective Analysis of 105 Cases

“…Selection of treatment is based on the child's age, lesion localization, prevalence and family preference. It has impact on success in clinic type (34). Various treatment guides are being discussed (34)(35)(36)(37)(38).…”