Clinical and Demographic Characteristics of Children with Vitiligo: Retrospective Analysis of 105 Cases

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.