Update on childhood vitiligo

Abstract

A cyclic approach to therapy should be used wherein topical agents are altered every 6-8 months and technology is used as an alternative after achievement of maximal topical response. With cyclic therapy and early disease intervention, good cosmetic outcomes may be achievable, particularly in localized cases.

Childhood Vitiligo

“…Toplumda %0,3-1,1 sıklığında görülen olguların hemen hemen yarısının 20 yaşından önce, %25'inin de 14 yaşından önce başladığı gösterilmiştir 1 . Pediyatrik yaş grubuna ait kesin prevelans ise bilinmemektedir.…”

Ultraviolet B (UVB) Phototherapy in the Treatment of Vitiligo

“…In children, disease control and repigmentation is achieved with biweekly treatments for 12 weeks and continues for 12 months. At this point, 80% of pediatric patients have stabilization of disease (Silverberg, 2010). Serial photography is recommended every 2-3 months to monitor disease progress, failure to respond, and safety, according to well-developed protocols for adults (Gawkrodger, Ormerod et al, 2008).…”

“…It has been shown to be more effective than PUVA photochemotherapy, without the adverse side effect profile of psoralen (Table 1) (Bhatnagar, Kanwar et al, 2007;Yones, Palmer et al, 2007). Evidence-based guidelines suggest that NB-UVB should be used instead of PUVA in both adult and pediatric patients who have treatment-resistant disease, widespread involvement (BSA > 10-20%), or disease that severely affects quality of life Gawkrodger, Ormerod et al, 2008;Silverberg, 2010). Furthermore, NB-UVB is suggested as the best choice for generalized disease, with topical immunomodulators (i.e., pimecrolimus cream or tacrolimus ointment) reserved for localized patches (Stinco, Piccirillo et al, 2009).…”

The Psychosocial Aspects of Vitiligo: A Focus on Stress Involvement in Children with Vitiligo

“…Age, change of location, and situational or environmental alterations can also be predictors of stress. About half of vitiligo vulgaris patients have onset of their illness during childhood, which can increase psychological distress during the formative years (Siverberg, 2010). On the other hand, in the prepubertal period, children are not focused yet on their physical appearance, so an early onset could also act as a "protective factor", enabling the child to develop compensatory mechanisms of coping with disease and ways to strengthen selfesteem (Hill-Boeuf & Porter, 1984).…”