patients who were not treated had limited involvement. Ninety-four patients (85.5%) were treated with topical therapies. Topical therapies included topical corticosteroids (mometasone 0.1% furoate cream, betamethasone 0.025% valerate cream, desonide 0.05% cream) and topical calcineurin inhibitors (tacrolimus 0.1% ointment, tacrolimus 0.03% ointment, pimecrolimus 1% cream). Eight patients (7.3%) underwent phototherapy (NB-UVB, 308-nm excimer lamp, UVA1) in combination with topical therapies.The mean duration of treatment was 12.9 AE 11.0 months (range: 1-61 months). Of the 72 patients with documented outcomes, there was good response in 9 patients (12.5%), partial response in 50 (69.4%) patients and poor response in 13 (18.1%) patients. There was no significant difference in treatment outcomes between segmental and non-segmental disease, age of onset, duration of disease and BSA involvement.Although the age of onset and gender ratio of our patients was similar to other cohorts, there was an overrepresentation of darker-skinned races in our study population. This may be due to the disease being more cosmetically significant in darker-skinned individuals. [2][3][4] Prompt and effective treatment is necessary to reduce the progression of vitiligo and its subsequent psychosocial impact, especially in darker-skinned patients. The first-line treatment of vitiligo in paediatric patients includes topical corticosteroids, topical calcineurin inhibitors or a combination of both. Several studies report a 45-60% response to topical steroids, while several other retrospective studies have shown the effectiveness of topical calcineurin inhibitors. 3,[5][6][7] A combination of topical corticosteroid and topical calcineurin inhibitor may show better response than monotherapy. 8 However, it can take months for adequate treatment response. 9 In children with more extensive disease or poor response to topical treatments, phototherapy is a relatively effective option. A study done by Koh et al. in Singapore showed good response of at least 50% repigmentation in 74% of paediatric patients treated with NB-UVB phototherapy, and in 53% of patients treated with excimer lamp phototherapy. 10 In conclusion, we have described the characteristics of a cohort of Asian children with vitiligo. Topical treatment remains an effective option, especially in children with limited involvement, while phototherapy may be used in more extensive or recalcitrant disease. Further research can be performed to compare various treatment modalities and monitor for efficacy and disease progression.
