Vitiligo-childhood onset commonly under 10 years

In a Tunisian single-centre study, over half of the children with vitiligo were 1–8 years old at diagnosis. Due to the lack of a standard, administered therapies varied with a preference for topical corticosteroids (TCS) in monotherapy or combination treatment.

To gather insight into childhood-onset vitiligo, a single-centre study on clinical profile and therapeutic management was conducted in Tunisia. The study included 205 young patients observed from 2006 to 2021 [1]. It comprised a little more girls than boys, with a mean age of 10.2. On average, 14 months passed before the diagnosis, and 55% of the children had an early onset at the age of 1–8 years at first lesion manifestation. Common vitiligo constituted the great majority of clinical varieties (93.2%). Segmental, guttate, and linear vitiligo only presented in a few cases. Face (44%), lower (36.5%), and upper limbs (25.4%) were involved most often. Over half of the children presented with generalised vitiligo (54.1%), while 45.8% suffered from localised disease. In 14% of cases, other family members also had a diagnosis of vitiligo.

As no standard therapy for children with vitiligo is available, treatments showed great variety. More than one-third was treated with TCS (36%), 17% with a combination of TCS and antioxidants, and 11% received TCS plus tacrolimus. Among other treatments used were: TCS plus calcipotriol (8%), tacrolimus monotherapy (7%), and 308-nm excimer lamp (5%). Overall, these therapies were beneficial in about three-quarters of the cases, with 8% achieving complete remission, 21% stable disease, and 48% developing re-pigmentation. In contrast, 23% experienced an extension of their lesions during the treatment.

In summary, the authors stated that local treatments, in particular TCS alone or combined with other agents, are the most privileged in childhood vitiligo as they are well tolerated and associated with good response.

1. Mrad A, et al. Childhood vitiligo: a study of 205 Tunisian children. P033, SPIN 2022 Congress, 06–08 July, Paris, France.

 

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Posted on 26 August 202217 May 2024