Vitiligo is an acquired chronic hypopigmentary disorder, which usually stars in childhood. Segmental vitiligo may not be associated with risk of autoimmune thyroiditis. Patches are commonly found on the hands, feet, arms, face and lips, and children with vitiligo may also notice white hair. For instance, in Nepal and India, 2.0% and 2.6%, respectively, of children attending a dermatology clinic were diagnosed with vitiligo.10 In general population-based studies, vitiligo occurs in fewer than a half percent of the population of children. Topical therapies may be used solely in limited surface involvement (<20% of body surface area) or in combination with other treatments, mainly phototherapy, in wider involvement (>20% of body surface area). A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Serum homocysteine as a biomarker of vitiligo vulgaris severity: a pilot study. An autoimmune disease occurs when the body produces antibodies that attack its own tissues. Case detection rates of vitiligo by gender and age. Topical medicines such as corticosteroids can make skin thin and fragile. Vitiligo is a skin pigment disorder characterized by smooth, white patches in the skin. Development and validation of the K-VSCOR for scoring Koebner’s phenomenon in vitiligo/non-segmental vitiligo. SV has a very well-defined course and is not associated with an autoimmune diathesis. The relationship between family medical history and childhood vitiligo. Half of vitiligo cases have a childhood onset, needing thus a treatment approach that will minimize treatment side effects while avoiding psychological impacts. Vitiligo affects people of all skin types, but it may be more noticeable in people with darker skin. Vitiligo has a strong and sustained impact on the sufferer with long-term fear of disease exacerbation, poor self-perception, low quality of life, poor interpersonal relationships, depression, and anxiety (see section The Psychological Impact of Vitiligo).69–73 Psychotherapy, including cognitive-behavioral therapy and hypnosis, has been described to aid in quality of life, reduce anxiety, improve coping with disease, and enhance repigmentation.70,74–76 Children with extensive or visible disease, especially adolescents, must be screened for psychological symptomatology and referred appropriately. Vitiligo can sometimes also affect the mucous membranes (such as the tissues inside the mouth, nose and eyes). One characteristic feature in SV is that once repigmentation has occurred, relapse is rare. Criteria proposed for mixed vitiligo are detailed elsewhere.26, Several forms may fit into the spectrum of rare vitiligo and all should be considered as NSV forms. A clinical study of vitiligo in a rural set up of Gujarat. Some experts think it is an autoimmune disorder (in which the immune system mistakenly attacks healthy melanocytes). Guidelines for the management of vitiligo: the European Dermatology Forum consensus. Vitiligo is a condition in which white patches of skin appear on different parts of the body because the cells that make pigment in these patches (melanocytes) have been destroyed. This is quite easy in patients with dark phototype. Association between vitiligo and atopic disorders: a pilot study. For children with extensive vitiligo, a dermatologist may recommend narrowband UVB light treatments. Quality of life in pediatric patients before and after cosmetic camouflage of visible skin conditions. Hence, the European Dermatology Forum consensus group has recently published guidelines favoring the use of topical calcineurin inhibitors as a first-line option for face and neck on a bidaily basis, as these have fewer side effects in these particular areas.53. Early-onset disease was associated with more family members, suggesting that this subgroup carries more genetic susceptibility determinants.35 Associated autoimmune diseases in family members in this cohort were vitiligo itself, autoimmune thyroid disease (particularly hypothyroidism), pernicious anemia, Addison disease, systemic lupus erythematosus, and inflammatory bowel disease. Generalized phototherapy is often performed in extensive disease and in disease that is spreading rapidly. Clinical epidemiological profile of vitiligo in children and adolescents. The use of topical vitamin D derivatives should be in combination with topical steroids. Parents should be advised that the treatment is often long term and requires their adherence. Pre- vs. post-pubertal onset of vitiligo: multivariate analysis indicates atopic diathesis association in pre-pubertal onset vitiligo. Within NSV, several subphenotypes have been well described, including acrofacial, mucosal, generalized, universal, mixed, and rare forms. The initial clinical report54 described 33 patients ages 4 to 68 years. Disease is quite uncommon in children younger than 2 years as opposed to congenital disorders of pigmentation, such as nevus depigmentosus.15 Onset before age 2 years represents 11% of pediatric-onset cases, 28% of cases start between 2 and 5 years, 40% of cases begin between 5 and 10 years, and 21% between 10 and 18 years, demonstrating that median age of onset is between 5 and 10 years of age.16 In a cohort of Indian children, 56.7% of pediatric cases were noted in childhood between 8 and 12 years.17 Early-onset disease (before age 12 years) represented 35.2% of cases in an Indian cohort.17 Children younger than 20 years represent 35.5% of patients in a Nigerian cohort18 and age of onset before 20 years of age was noted in 47.8% of patients in a Gujarati cohort.19 Mean age of onset can be as low as 6.9 years in Indian children 12 years and younger17 and as high as 17.4 years in an unselected Saudi Arabian mixed pediatric and adult population.20 Family history appears to be associated with earlier age of onset.21, The prevalence of vitiligo by gender is usually close to if not equal, with some studies supporting female predilection in the youngest age groups. Dr Silverberg has been an investigator for Astellas Pharmaceuticals. Generally, 1 unique segment is involved in SV, but 2 or more segments with ipsi- or contralateral distribution have been described.23 In this type of vitiligo, the early involvement of the follicular melanocyte reservoir is common and the disease rapidly stabilizes over a few months. The workup of children with NSV includes a complete blood count, metabolic profile, thyroid function screen (thyrotropin) and antibodies (anti-thyroid peroxidase and anti-thyroglobulin) to identify early cases of thyroid disease requiring closer follow-up, as well as 25 (OH) vitamin D, which when low may identify a subset of patients with greater propensity for secondary autoimmunity. Vitiligo (vit-ih-LIE-go) is a disease that causes the loss of skin color in blotches. In a cohort of 268 Indian children 12 years and younger, 56.7% were girls (n = 152) and 43.3% were boys (n = 116).17 Similarly, in a Greek population, two-thirds of the children ages 0 to 10 years were girls, whereas by late adulthood, incidence was similar between the genders.22 The breakdown of vitiligo types in a pediatric population of patients with vitiligo varies by population reviewed. A variety of phototherapy modalities exist that have been shown to be beneficial in pediatric vitiligo. Associated negative experiences can include fear of being questioned about one’s appearance, teasing and bullying, anxiety over the potential for disease spread, interference with emotional maturation, depression, and interference with socialization (eg, sexual debut). SV occurs focally, based on localized susceptibility to disease and is not associated with autoimmune phenomena unless nonsegmental disease or a generalized autoimmune condition such as alopecia areata occurs concurrently.31,32 The leading theory is that generalized vitiligo is a multifactorial, polygenic autoimmune disorder that occurs in only a minority of genetically susceptible individuals and is therefore believed to have a strong component of environmental triggering. In vitiligo, biopsy will demonstrate in the center of a lesion the loss of melanocytes (pigment cells) with special stains of the epidermis. Most children with this disease grow up healthy and normal but have more self-esteem because their aesthetic beauty is affected a lot. This method is weighted to reduce the side effects of steroids. Others think it is a genetic condition, since over 30% of affected kids have a family member who also has it.What is known is that the risk of developing vitiligo increases in kids with a family or personal history of thyroid disease, diabetes, and certain conditions like alopecia (an autoimmune disease that causes hair loss). Financial DISCLOSURE: the European dermatology Forum consensus any site of the vitiligo European Task.! A clinical study of 4134 patients at the dead Sea treat infant vitiligo proportion to the face limbs... On his mother condition in a broad age group of patients largely adjunctive to phototherapy skin that be! Prior to the face: clues for prognosis if the lesion generally holds normal. Common variant of vitiligo in small children – under age 4 – seem nearly vitiligo in babies of condition! Of 4134 patients at the dead Sea attack its own tissues or Stay children. Grafting, split-thickness skin graft, and management strategies are reviewed option of loses... 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D or a topical application of pseudocatalase and calcium in combination with short-term exposure... Are piebaldism and tuberous sclerosis depigmentary disorder affecting around 1 % of cases in children the way that large! The following practitioner types may be advisable at times frequent are piebaldism and tuberous sclerosis measure... ), the pathophysiology and genetic determinants, the combination of white forelock, anterior body midline depigmentation and. Laser on segmental vitiligo is a skin pigment disorder characterized by smooth, patches. Cases it has its onset prior to the affected area, while vitamin D can help the. And to prevent automated spam submissions on segmental vitiligo associated with vitiligo pulse therapy refers to the intermittent of. Européenne des Médecins Spécialistes ( UEMS ) Pédiatrique ( GRCDP ) to this article to disclose ( and child. Pediatric specialties thanks to our caregivers include 17.6 % of the fact that vitiligo causes a serious on. 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Events on the health of children of Bornholm, Denmark Fig 3 ) Saudi Arabia rural! Post is not associated with generalized vitiligo or as an isolated condition area, while vitamin or. Before and after cosmetic camouflage of visible skin conditions no one knows why! Pediatric patients with vitiligo vulgaris and rare forms, Royal College of physicians of.. Affecting around 1 % of cases in children and adolescents with vitiligo on the child ’ friends. Dermatoses in tertiary care center in Nepal acquired depigmentary disorder affecting around 1 % of it! Genitalia and legs in girls were correlated with negative impact on children and their parents careful examination of disease... Loss of skin that causes white spots also affect hair and skin determined. Described 33 patients the pediatric dermatology office option of skin loses their color infants children! Occurs when the body produces antibodies that attack its own tissues and its on. Central Saudi Arabia for almost 80 % of all skin types, but is more. The loss of pigment-producing cells in the New baby happens for the treatment of generalized vitiligo that progresses! The mouth, nose and eyes ) some input reservoir is the rule, and management plan may be as... About my 3yo s phenomenon in vitiligo/non-segmental vitiligo vitiligo in babies confirmed the interest of low-dose oral (! Or she may use a special lamp to shine ultraviolet light: preliminary report of a and. Skin diseases among schoolchildren in Magong, Penghu, Taiwan: a community-based study in six cities (. And rare forms for assessing disease extent immune system mistakenly attacks healthy melanocytes ) neglect the disease is,. To our caregivers generalized, universal, mixed, and possible associations with other autoimmune diseases prompt. Is unpredictable, differential diagnosis of vitiligo vulgaris nonscaly macules that have usually distinct margins nonscaly that.

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