Vitiligo: Treatment Approach in Children

Abstract

Vitiligo is a common acquired condition in which the skin and hair become depigmented or hypopigmented. The prevalence of vitiligo ranges between 0.5% and 2% worldwide, and 50% of the cases present before 20 years. Given the visibility of the disease, vitiligo can have psychological effects including low self-esteem, teasing by others, and social anxiety. Topical therapies and phototherapy can safely and effectively repigment the skin and improve quality of life. Here we provide a review of the clinical presentation, epidemiology, associations, pathogenesis, and treatment of vitiligo in the pediatric population. <H4>ABOUT THE AUTHORS</H4> <p>Arin L. Isenstein, MD, is Resident Physician, Department of Dermatology, University of North Carolina; Dean S. Morrell, MD, is Associate Professor, Department of Dermatology, University of North Carolina; Craig N. Burkhart, MD, is Assistant Professor, Department of Dermatology, University of North Carolina.</p> <p>Address correspondence to: UNC Dermatology, 3100 Thurston-Bowles Bldg., CB#7287, Chapel Hill, NC, 27599-7287; fax 919-966-3898; e-mail <A HREF="MAILTO:aisenste@unch.unc.edu">aisenste@unch.unc.edu</a>.</p> <p>Dr. Isenstein, Dr. Morrell, and Dr. Burkhart have disclosed no relevant financial relationships.</p> <p>doi: 10.3928/00904481-20090522-01</p>

Current Management of Pediatric Vitiligo

“…Topical calcineurin inhibitors (tacrolimus 0.03 %/0.1 % and pimecrolimus 1 %), FDA approved for the treatment of atopic dermatitis, have been reported to be safe and efficacious [40] in pediatric vitiligo, especially on the head and neck, in patients with disease for\5 years, on intertriginous and genital skin, in facial segmental disease, in dark patients [41,42], on lesions on the head and neck (especially segmental facial type) [43], and in patients with a Fitzpatrick skin type of 3-4 [32,43]. Children are nine times as likely as adults to get a good response [44].…”

“…Localized side effects of topical steroids include atrophy, striae, telangiectases, perioral dermatitis, and glaucoma (when applied in the periocular location) [30]. Systemic absorption is of concern, especially in smaller children with potential for hypothalamicpituitary-adrenal axis suppression/iatrogenic Cushing's syndrome [31][32][33].…”

Childhood Vitiligo

“…Yapılan çalışmalarda NB-UVB ile benzer etkinlik elde edilen tedavinin yan etki profili daha yüksek olduğu için çocuklarda kullanımı daha sınırlıdır 15 .…”

Screening and identification of differentially expressed serum proteins in patients with vitiligo using two‑dimensional gel electrophoresis coupled with mass spectrometry

“…Vitiligo is an acquired autoimmune disease characterized by primary, localized, or generalized white spots on the skin and mucosae due to the destruction of epidermal melanocytes. Approximately 0.5-2% of the global population is affected by vitiligo (1), and the incidence of this disease in China is 0.1-2.7% (2). In the progressive stage of vitiligo, the emergence of new lesions or the enlargement of original lesions occurs from 6 weeks to 1 year, and the stable stage of the disease is reached only when lesions have been stable for more than 1 year or with spontaneous pigment regeneration.…”