Clinical and Demographic Characteristics of Children with Vitiligo: Retrospective Analysis of 105 Cases
Abstract
Objectives: Vitiligo is a disease for which the cause is not
clearly known public but is common and is characterised by depigmented macules. It’s incidence rate ranges between 0.1- 11%.
Incidence among children is not known clearly but it
has been reported that in half of the cases lesions start before the age of,
and in 25% they start before 10-14 years and
it has different characteristics than that in adults. The aim of this
study is to define the clinical and demographic characteristics of childhood
vitiligo, identify the accompanying diseases and the treatment options that are
provided.
Material and Methods: The files of 105 paediatric patients diagnosed with
vitiligo in our hospital’s dermatology department during the 2011-2018 period
have been retrospectively examined. Age, gender, starting age, disease
duration, lesion area, vitiligo type, family vitiligo history, blood tests and
accompanying diseases have been recorded. Vitiligo types have been divided into
2 main groups, namely segmental and no segmental. Cases
with generalized (vulgar), focal, acral, acrofacial vitiligo have been included
in non-segmental vitiligo cases.
Results:
44.76% of the patients are female. The average age was 10.98±4.77 years,
the average age when the condition started was 9.63±4.53 years and average
duration of the disease was 19.19±19,60 months (1.59 years). Number of cases in
0-2 age group was 7 (6.66%), 3-5 age group was 10 (9.52%), 6-11 age group was
32 (30.47%), 12-18 age group was 56 (53.33%). In terms of duration of the disease, 0-2 months included 12 patients (11.42%), 3-6 months included 11
patients (10.47%), 7 months to 1 year included 9 patients (8.57%), and over a
year included 73 patients (6.52%). With regards to the types of vitiligo, 6.66%
(n=7) had segmental vitiligo, 92.38% (n=97) had non-segmental vitiligo,
0.95% (n=1) had mixed type vitiligo.
53.60% (n=52) of non-segmental vitiligo was focal vitiligo, 31.95% (n=31) was
vitiligo vulgaris 7.21% (n=7) was acrofacial and 7.21% (n=7) was acral type. In terms of focal vitiligo 40.38% (n=21) had
cheek involvement, 23.07% (n=12) periorbital involvement, 11.53% (n=6) perioral
involvement, 7.69% (n=4) genital involvement and five cases (9.61%) had
multiple involvements.
In 30.4% of the cases (n=32), one or more
coexisting disease has been observed to exist.
Treatment options differed
by age. While topical steroids and calcineurin inhibitors have been preferred
in younger ages and in limited lesions, while in older ages and in more spread
lesions phototherapy and systemic treatment methods have been practised.
Conclusion: This study is addressing the clinical and demographic
characteristics of children with vitiligo as well as the practised treatment
options. In contrast to other studies, this study has concluded more incidences
among males. Regarding people in the early stages of vitiligo and in lesions
localised in head-neck area, micro-therapy has been observed to be effective
and calcineurin inhibitors have hastened re-pigmentation.
Keywords
References
- References1.Silverberg NB. The Epidemiology of vitiligo. Curr Derm Rep 2015;4:36-43.
- 2.Phiske MM. Vitiligo in children: a birds eye view. Curr Pediatr Rev 2016;12(1):55-66.
- 3.Ezzedine K, Silverberg N. A Practical approach to the diagnosis and treatment of vitiligo in children. Pediatrics 2016 Jul;138(1). pii: e20154126.
- 4.Gianfaldoni S, Tchernev G, Wollina U Lotti J, Satolli F, França K, et al. Vitiligo in children: a better understanding of the disease. Open Access Maced J Med Sci 2018 Jan 20;6(1):181-184.
- 5. Halder RM. Childhood vitiligo. Clin Dermatol 1997;15:899-906.
- 6.Handa S, Dogra S. Epidemiology of childhood vitiligo: a study of 625 patients from North India. Pediatr Dermatol 2003;20:207-10.
- 7. Nicolaidou E, Antoniou C, Miniati A, Lagogianni E, Matekovits A, Stratigos A, et al. Childhood and later-onset vitiligo have diverse epidemiologic and clinical characteristics. J Am Acad Dermatol 2012;66:954-8.
- 8. Hu Z, Liu JB, Ma SS, Yang S, Zhang XJ. Profile of childhood vitiligo in China: an analysis of 541 patients. Pediatr Dermatol 2006;23:114-6.
- 9.Al-Mutairi N, Sharma AK, Al-Sheltawy M, Nour-Eldin O. Childhood vitiligo: a prospective hospital-based study. Australas J Dermatol 2005;46:150-3.
- 10. Habib A. Vitiligo in children: a distinct subset. J Coll Physicians Surg Pak 2016;26(3):173-6.
- 11. Aksoy F. Evans S,,Karaduman A. Çocukluk çağında vitiligo: 63 vakanın prospektif olarak değerlendirilmesi.Turkiye Klinikleri J Dermatol 2008;18:67-71.
- 12.Arıcan O, Koç K, Ersoy L. Clinical characteristics in 113 Turkish vitiligo patients. Acta Dermatovenerol Alp Pannonica Adriat 2008;17(3):129-32.
- 13.Ezzedine K, Lim HW, Suzuki T, Katayama I, Hamzavi I, Lan CC, et al. Revised classification/nomenclature of vitiligo and related issues: the Vitiligo Global Issues Consensus Conference. Pigm Cell Melanoma Res 2012;25:E1–13.
- 14. Kartal D, Borlu M, Çınar SL, Kesikoğlu A, Utaş S. Thyroid abnormalities in paediatric patients with vitiligo: retrospective study. Postepy Dermatol Alergol 2016 Jun;33(3):232-4.
- 15. Kayal A, Gupta LK, Khare AK, Mehta S, Mittal A, Kuldeep CM. Pattern of Childhood Onset Vitiligo at a Tertiary Care Centre in South- West Rajasthan. Indian J Dermatol. 2015;60(5):520.
- 16.Agarwal S, Ojha A, Gupta S. Profile of vitiligo in kumaun region of Uttarakhand, India. Indian J Dermatol 2014;59(2):209. 17. Gandhi S, Shamanur M, Shashikiran A R, Kusagur M, Sugareddy, Bhaskar V. A study of clinico-epidemiological and dermoscopic patterns of vitiligo in pediatric age group. Indian J Paediatr Dermatol 2017;18:292-8.
- 18.Marinho FS, Cirino PV, Fernandes NC. Clinical epidemiological profile of vitiligo in children and adolescents. An Bras Dermatol 2013;88(6): 1026–28.
- 19. Cho S, Kang HC, Hahm J. Characteristics of vitiligo in Korean children. Pediatr Dermatol 2000;17:189-93.
- 20.Alzolibani A. Genetic epidemiology and heritability of vitiligo in the Qassim region of Saudi Arabia. Acta Dermatovenerol Alp Panonica Adriat 2009;18(3):119-25.
- 21.Wang X, Du J, Wang T, Zhou C, Shen Y, Ding X, et al. Prevalence and clinical profile of vitiligo in China: a community-based study in six cities. Acta Derm Venereol 2013;93(1):62–65.
- 22- Pajvani U, Ahmad N, Wiley A, Levy RM, Kundu R, Mancini AJ, et al. The relationship between family medical history and childhood vitiligo. J Am Acad Dermatol2006;55:238-44.
- 23. Narita T, Oiso N, Fukai K, Kabashima K, Kawada A, Suzuki T. Generalized vitiligo and associated autoimmune diseases in Japanese patients and their families. Allergol Int 2011;60:505–8.
- 24.Gönül M, Cakmak SK, Oğuz D, Gül U, Kiliç S. Profile of vitiligo patients attending a training and research hospital in Central Anatolia: a retrospectivestudy. J Dermatol 2012 Feb;39(2):156-9.
- 25. Topal O, Duman H, Gungor S, Kocatürk E, Can P.Evaluation of the clinical and sociodemographic features of Turkish patients with vitiligo. Acta Dermatovenerol Croat 2016 Jun;24(2):124-9. 26.Zettinig G, Tanew A, Fischer G, Mayr W, Dudczak R, Weissel M. Autoimmune diseases in vitiligo: do antinuclear antibodies decrease thyroid volume? Clin Exp Immunol 2003;131: 347-54.
- 27.Afsar FS, Isleten F. Prevalence of thyroid function test abnormalitiesand thyroid autoantibodies in children with vitiligo. IndianJ Endocrinol Metab 2013;17(6):1096–9.
- 28.Prindaville B, Rivkees SA. Incidence of vitiligo in children with Graves'disease and Hashimoto's thyroiditis. Int J Pediatr Endocrinol 2011;(1):18.
- 29.Uncu S, Yayli S, Bahadır S, Okten A, Alpay K. Relevance of autoimmune thyroiditis in children and adolescents with vitiligo. Int J Dermatol 2011;50:175-9.
- 30.Ertekin V, Selimoglu MA, Altinkaynak S. Celiac disease in childhood:evaluation of 140 patients. Eurasian J Med 2009;41(3):154-7.
- 31. Zhang X, Wang W, Li Y, Wang H, Liu R, Zhu L. Serum 25-hydroxyvitamin D status in chinese children with vitiligo: a case-control study. Clin Pediatr (Phila) 2018;57(7):802-5.
- 32.Nejad SB, Qadim HH, Nazeman L, Fadaii R, Goldust M. Frequency of autoimmune diseases in those suffering from vitiligo in comparison with normal population.Pak J Biol Sci 2013 Jun 15;16(12):570-4. 33.Kalkanli N, Kalkanli S. Classification and comparative study of vitiligo in Southeast of Turkey with biochemical and immunological parameters. Clin Ter 2013;164(5):397-402.
- 34. Driessche FV, Silverberg N. Pediatr current management of pediatric vitiligo. Drugs 2015; 17:303–13.
- 35.Taieb A, Alomar A, Böhm M, Dell'anna ML, De Pase A, Eleftheriadou V, et al. Vitiligo European Task Force (VETF); European Academy of Dermatology and Venereology (EADV); Union Europe´enne desMe´decinsSpe´cialistes (UEMS). Guidelines for the management of vitiligo: the European Dermatology Forum consensus. Br J Dermatol 2013;168(1):5-19.
- 36. Gianfaldoni S, Wollina U, Tchernev G, Lotti J, França K, Lotti T. Vitiligo in children: a review of conventional treatments. Open Access Maced J Med Sci 2018 ;6(1):213-7.
- 37. Baykal L, Bahadır S. Çocuklarda vitiligo tedavsi ve yeni tedavi yaklaşımları. 2015 dermatoz /2/dermatoz doi:10.15624 dermatoz 15062d2.
- 38.Yazici S, Günay B, Başkan EB, Aydoğan K, Saricaoğlu H, Tunali Ş. The efficacy of narrowband UVB treatment in pediatric vitiligo: a retrospective analysis of 26 cases. Turk J Med Sci 2017 Apr18;47(2):381-4.
Abstract
References
- References1.Silverberg NB. The Epidemiology of vitiligo. Curr Derm Rep 2015;4:36-43.
- 2.Phiske MM. Vitiligo in children: a birds eye view. Curr Pediatr Rev 2016;12(1):55-66.
- 3.Ezzedine K, Silverberg N. A Practical approach to the diagnosis and treatment of vitiligo in children. Pediatrics 2016 Jul;138(1). pii: e20154126.
- 4.Gianfaldoni S, Tchernev G, Wollina U Lotti J, Satolli F, França K, et al. Vitiligo in children: a better understanding of the disease. Open Access Maced J Med Sci 2018 Jan 20;6(1):181-184.
- 5. Halder RM. Childhood vitiligo. Clin Dermatol 1997;15:899-906.
- 6.Handa S, Dogra S. Epidemiology of childhood vitiligo: a study of 625 patients from North India. Pediatr Dermatol 2003;20:207-10.
- 7. Nicolaidou E, Antoniou C, Miniati A, Lagogianni E, Matekovits A, Stratigos A, et al. Childhood and later-onset vitiligo have diverse epidemiologic and clinical characteristics. J Am Acad Dermatol 2012;66:954-8.
- 8. Hu Z, Liu JB, Ma SS, Yang S, Zhang XJ. Profile of childhood vitiligo in China: an analysis of 541 patients. Pediatr Dermatol 2006;23:114-6.
- 9.Al-Mutairi N, Sharma AK, Al-Sheltawy M, Nour-Eldin O. Childhood vitiligo: a prospective hospital-based study. Australas J Dermatol 2005;46:150-3.
- 10. Habib A. Vitiligo in children: a distinct subset. J Coll Physicians Surg Pak 2016;26(3):173-6.
- 11. Aksoy F. Evans S,,Karaduman A. Çocukluk çağında vitiligo: 63 vakanın prospektif olarak değerlendirilmesi.Turkiye Klinikleri J Dermatol 2008;18:67-71.
- 12.Arıcan O, Koç K, Ersoy L. Clinical characteristics in 113 Turkish vitiligo patients. Acta Dermatovenerol Alp Pannonica Adriat 2008;17(3):129-32.
- 13.Ezzedine K, Lim HW, Suzuki T, Katayama I, Hamzavi I, Lan CC, et al. Revised classification/nomenclature of vitiligo and related issues: the Vitiligo Global Issues Consensus Conference. Pigm Cell Melanoma Res 2012;25:E1–13.
- 14. Kartal D, Borlu M, Çınar SL, Kesikoğlu A, Utaş S. Thyroid abnormalities in paediatric patients with vitiligo: retrospective study. Postepy Dermatol Alergol 2016 Jun;33(3):232-4.
- 15. Kayal A, Gupta LK, Khare AK, Mehta S, Mittal A, Kuldeep CM. Pattern of Childhood Onset Vitiligo at a Tertiary Care Centre in South- West Rajasthan. Indian J Dermatol. 2015;60(5):520.
- 16.Agarwal S, Ojha A, Gupta S. Profile of vitiligo in kumaun region of Uttarakhand, India. Indian J Dermatol 2014;59(2):209. 17. Gandhi S, Shamanur M, Shashikiran A R, Kusagur M, Sugareddy, Bhaskar V. A study of clinico-epidemiological and dermoscopic patterns of vitiligo in pediatric age group. Indian J Paediatr Dermatol 2017;18:292-8.
- 18.Marinho FS, Cirino PV, Fernandes NC. Clinical epidemiological profile of vitiligo in children and adolescents. An Bras Dermatol 2013;88(6): 1026–28.
- 19. Cho S, Kang HC, Hahm J. Characteristics of vitiligo in Korean children. Pediatr Dermatol 2000;17:189-93.
- 20.Alzolibani A. Genetic epidemiology and heritability of vitiligo in the Qassim region of Saudi Arabia. Acta Dermatovenerol Alp Panonica Adriat 2009;18(3):119-25.
- 21.Wang X, Du J, Wang T, Zhou C, Shen Y, Ding X, et al. Prevalence and clinical profile of vitiligo in China: a community-based study in six cities. Acta Derm Venereol 2013;93(1):62–65.
- 22- Pajvani U, Ahmad N, Wiley A, Levy RM, Kundu R, Mancini AJ, et al. The relationship between family medical history and childhood vitiligo. J Am Acad Dermatol2006;55:238-44.
- 23. Narita T, Oiso N, Fukai K, Kabashima K, Kawada A, Suzuki T. Generalized vitiligo and associated autoimmune diseases in Japanese patients and their families. Allergol Int 2011;60:505–8.
- 24.Gönül M, Cakmak SK, Oğuz D, Gül U, Kiliç S. Profile of vitiligo patients attending a training and research hospital in Central Anatolia: a retrospectivestudy. J Dermatol 2012 Feb;39(2):156-9.
- 25. Topal O, Duman H, Gungor S, Kocatürk E, Can P.Evaluation of the clinical and sociodemographic features of Turkish patients with vitiligo. Acta Dermatovenerol Croat 2016 Jun;24(2):124-9. 26.Zettinig G, Tanew A, Fischer G, Mayr W, Dudczak R, Weissel M. Autoimmune diseases in vitiligo: do antinuclear antibodies decrease thyroid volume? Clin Exp Immunol 2003;131: 347-54.
- 27.Afsar FS, Isleten F. Prevalence of thyroid function test abnormalitiesand thyroid autoantibodies in children with vitiligo. IndianJ Endocrinol Metab 2013;17(6):1096–9.
- 28.Prindaville B, Rivkees SA. Incidence of vitiligo in children with Graves'disease and Hashimoto's thyroiditis. Int J Pediatr Endocrinol 2011;(1):18.
- 29.Uncu S, Yayli S, Bahadır S, Okten A, Alpay K. Relevance of autoimmune thyroiditis in children and adolescents with vitiligo. Int J Dermatol 2011;50:175-9.
- 30.Ertekin V, Selimoglu MA, Altinkaynak S. Celiac disease in childhood:evaluation of 140 patients. Eurasian J Med 2009;41(3):154-7.
- 31. Zhang X, Wang W, Li Y, Wang H, Liu R, Zhu L. Serum 25-hydroxyvitamin D status in chinese children with vitiligo: a case-control study. Clin Pediatr (Phila) 2018;57(7):802-5.
- 32.Nejad SB, Qadim HH, Nazeman L, Fadaii R, Goldust M. Frequency of autoimmune diseases in those suffering from vitiligo in comparison with normal population.Pak J Biol Sci 2013 Jun 15;16(12):570-4. 33.Kalkanli N, Kalkanli S. Classification and comparative study of vitiligo in Southeast of Turkey with biochemical and immunological parameters. Clin Ter 2013;164(5):397-402.
- 34. Driessche FV, Silverberg N. Pediatr current management of pediatric vitiligo. Drugs 2015; 17:303–13.
- 35.Taieb A, Alomar A, Böhm M, Dell'anna ML, De Pase A, Eleftheriadou V, et al. Vitiligo European Task Force (VETF); European Academy of Dermatology and Venereology (EADV); Union Europe´enne desMe´decinsSpe´cialistes (UEMS). Guidelines for the management of vitiligo: the European Dermatology Forum consensus. Br J Dermatol 2013;168(1):5-19.
- 36. Gianfaldoni S, Wollina U, Tchernev G, Lotti J, França K, Lotti T. Vitiligo in children: a review of conventional treatments. Open Access Maced J Med Sci 2018 ;6(1):213-7.
- 37. Baykal L, Bahadır S. Çocuklarda vitiligo tedavsi ve yeni tedavi yaklaşımları. 2015 dermatoz /2/dermatoz doi:10.15624 dermatoz 15062d2.
- 38.Yazici S, Günay B, Başkan EB, Aydoğan K, Saricaoğlu H, Tunali Ş. The efficacy of narrowband UVB treatment in pediatric vitiligo: a retrospective analysis of 26 cases. Turk J Med Sci 2017 Apr18;47(2):381-4.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Publication Date | June 26, 2020 |
| Submission Date | March 12, 2019 |
| Published in Issue | Year 2020 Volume: 14 Issue: 4 |
The publication language of Turkish Journal of Pediatric Disease is English.
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