|Year : 2014 | Volume
| Issue : 1 | Page : 20-23
Clinical profile of childhood vitiligo patients in Hadoti region in Rajasthan
Manali Jain, Suresh Kumar Jain, Ramesh Kumar, Prafull Mehta, Naresh Banjara, Sarita Kalwaniya
Department of Dermatology, Venereology, and Leprology, Government Medical College, Kota, Rajasthan, India
|Date of Web Publication||2-May-2014|
Suresh Kumar Jain
Department of Dermatology, Venereology, and Leprology, Government Medical College, Kota - 324 001, Rajasthan
Source of Support: None, Conflict of Interest: None
Background: Reports from different parts of the country have revealed wide variation in the clinical profile of childhood vitiligo. Variations exist with respect to age, sex, family history, Koebner phenomena and presence of other cutaneous disease.
Aim: The aim of the following study is to assess the clinical profile and other cutaneous disease in childhood vitiligo.
Materials and Methods: This study was designed to find the clinical characteristics of childhood vitiligo (in the age group < 12 years) in the Outpatient Department of Dermatology, Venereology and Leprology, Government medical college, Kota, between July 2012 and June 2013. A total of 35 childhood vitiligo patients were examined.
Results: Out of 35 children, 20 patients (57.14%) were female and 15 patients (42.86%) were male. In most of the patients, disease onset was < 10 year of age and mean age of onset was 6.64 1 year. The most common pattern observed in childhood vitiligo was vitiligo vulgaris (17 patients) followed by focal (9 patient). Other less common pattern were segmental (4 patients), mucosal (2 patients), mixed (1 patient), contact (1 patient), acrofacial (1 patient). Out of 35 patients, 6 patients had a family history, 12 patients had Koebner phenomena, and 3 patients had leucotrichia. Other cutaneous dermatoses was found in 4 patients out of which 3 patients had halo nevus and 1 patient had atopic dermatitis.
Conclusion: Childhood vitiligo in Hadoti region showed a preponderance in females and most common pattern were vitiligo vulgaris followed by focal vitiligo.
Keywords: Childhood Vitiligo, Koebner phenomenon, Halo nevus, Leucotrichia
|How to cite this article:|
Jain M, Jain SK, Kumar R, Mehta P, Banjara N, Kalwaniya S. Clinical profile of childhood vitiligo patients in Hadoti region in Rajasthan. Indian J Paediatr Dermatol 2014;15:20-3
|How to cite this URL:|
Jain M, Jain SK, Kumar R, Mehta P, Banjara N, Kalwaniya S. Clinical profile of childhood vitiligo patients in Hadoti region in Rajasthan. Indian J Paediatr Dermatol [serial online] 2014 [cited 2019 Nov 18];15:20-3. Available from: http://www.ijpd.in/text.asp?2014/15/1/20/131831
| Introduction|| |
Vitiligo is an acquired progressive disorder in which some or all of the melanocytes in the interfollicular epidermis, and occasionally those in hair follicles are destroyed. It affects between 0.5% and 4% of the world population. 
It can develop anytime in life, including neonatal period and childhood. Childhood Vitiligo deserves special attention because in 50% patient, the onset of disease is before 20 years of age and in 25% of cases, it starts before the age of 10 years. 
In various studies, the prevalence of childhood vitiligo (age < 12 years) has been quoted to be around one quarter of vitiligo patients of all ages. In two Indian studies, the prevalence has been reported to be 26%  (south India) and 23.3%  (north India) respectively. The prevalence of Segmental Vitiligo was found higher in children (17-29%) as compared to that in adults (5%). 
There is a paucity of data on the epidemiology of childhood vitiligo in India and also from world-wide. In our study, we report the epidemiological and clinical profile of childhood vitiligo.
| Materials and Methods|| |
This study was conducted on 35 childhood vitiligo patients reporting to the Outpatient Department of Dermatology, Venereology and Leprology, Government medical college, Kota between July 2012 and June 2013. All patients diagnosed to having clinical vitiligo with age less than 12 year and willing to enroll for the study were included in the study. Unwilling patients, patients above the age of 12 years and patients with other form of hypopigmentory disorder such as Pityriasis versicolor, Piebaldism, Albinism and Pityriasis alba were excluded from the study.
After taking an informed consent, demographic and disease data including site of onset and age of onset was noted. Emphasis was given to pattern of disease, duration of disease, presence of Koebner phenomenon and leucotrichia. History of other cutaneous disease were also noted. Patients were subjected to a detailed history and clinical examination.
| Results|| |
Out of 35 children, 20 patients (57.14%) were female [Table 1] and 15 patients (42.86%) were male. Most patients belong to 6-9 year of age. Youngest patient was of 1 year age. Out of them, 19 patients were from urban background while rest 16 patient were from a rural background. In most of patient, disease onset was <10 year and mean age of onset was 6.64 ± 1 year.
Most common site of onset was face (25.71%) followed by lower limb (20%) [Table 2]. The most common pattern observed in childhood vitiligo was vitiligo vulgaris (48.5%), followed by focal vitiligo (25.7%). Other less common pattern were segmental (11.42%), mucosal (5.7%), mixed (2.8%), contact (2.8%) and acrofacial (2.8%) [Figure 1]a-d, [Figure 2], [Figure 3] and [Table 3].
|Table 3: Distribution of childhood vitiligo cases according to pattern of vitiligo|
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|Figure 1: (a) Vitiligo vulgaris, (b) segmental vitiligo, (c) mucosal vitiligo, (d) focal vitiligo|
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Out of total 35 patients, 6 patients (17.14%) of childhood vitiligo had a family history, while 12 patients (34.32%) showed Koebner phenomenon and 3 patients (8.5%) had leucotrichia [Table 4].
|Table 4: Distribution of childhood vitiligo cases according to leucotrichia, family history and Koebner phenomena|
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Out of 35 childhood vitiligo patient, 26 patients (74.28%) had less than 5% of body surface area involvement while 9 patients (25.71%) had 5-20% of body surface area involvement. Disease was progressive in all patients.
Other cutaneous dermatoses was found in 4 patient (11.42%) out of which 3 patients (8.57%) had halo nevus [Figure 4] and 1 patient (2.8%) had atopic dermatitis and no systemic disease was found to be associated in any childhood vitiligo patient.
| Discussion|| |
Age and Sex Distribution
In our study out of total 35 patients, 20 patients were female and 15 patients were male with a female to male ratio was 1.5:1. In earlier published reports on childhood vitiligo, the majority of cases were girls. The explanation could be due to the greater social stigma in girls affected by this condition. These results are in accordance with a study done by Handa and Dogra (P > 0.05). 
Out of 35 patients, 19 patients were from urban background while rest 16 patient were from rural background which indicate more awareness in urban patients.
Age of Onset
In our study most patients were in 6- 9 year age group which is different from the study done by Handa and Dogra where the most patients were in between 9 and12 years.  In most of patient disease onset was < 10 year and mean age of onset was 6.64 year.
Type of Vitiligo
The most common pattern observed in our study was vitiligo vulgaris in 17 patients (48.57%), followed by focal 9 patient (25.71%). Other less common pattern were segmental, mucosal, mixed, contact, acrofacial. Jaisankar et al. in their study of 90 children reported vitiligo vulgaris was most commonly observed pattern followed by segmental vitiligo as the second most frequent presentation occurring in 21% of patients, closely followed by focal vitiligo in 20.1%. 
Site of Initial Lesion
Most common site of onset was face in 9 patients (25.71%) followed by lower limb in 7 patients (20%). Handa and Dogra also reported that the most common site of onset was head and neck.  These result indicate that when lesion occur on cosmetically important site patient approach soon to doctor.
Body Surface Area Involvement
Out of 35 childhood vitiligo patient, 26 patient (74.28%) show < 5% body surface area involvement while 9 patient (25.71%) show 5-20% body surface area involvement.
In our study 17.14% patients show family history, while Handa and Dogra reported family history of vitiligo in 12% of children. Jaisankar et al. in their study have reported relatively lower figure of 3.3%. 
In our study (8.5%) patients show leucotrichia, while study done by Handa and Dogra reported leukotrichia in 12.3% of patients.  In our study (34.32%) patients show Koebner phenomena while Belliappa et al.  reported Kobner phenomenon in 24.6% of children, most commonly in vitiligo vulgaris variant. This may be due to increased proneness to trauma and exposure to sunlight.
In our study associated cutaneous disease was found in 4 patient (11.42%) out of which 3 patients (8.57%) had halo nevus and 1 patient (2.8%) had atopic dermatitis while Handa and Dogra al reported halo nevus in 4.4% of pediatric patients. 
| Conclusions|| |
Childhood vitiligo in Hadoti region showed a preponderance in females probably because patients or parents worry more and tend to seek treatment for cosmetically disfiguring, depigmenting patches more frequently in girls. Majority of patients (74.28%) had less than 5% body surface area involvement. The most common pattern observed in childhood vitiligo is vitiligo vulgaris (17 patients) followed by focal (9 patient).
| References|| |
|1.||Ortonne JP, Bose SK. Vitiligo: Where do we stand? Pigment Cell Res 1993;6:61-72. |
|2.||Iacovelli P, Sinagra JL, Vidolin AP, Marenda S, Capitanio B, Leone G, et al. Relevance of thyroiditis and of other autoimmune diseases in children with vitiligo. Dermatology 2005;210:26-30. |
|3.||Jaisankar TJ, Baruah MC, Garg BR. Vitiligo in children. Int J Dermatol 1992;31:621-3. |
|4.||Handa S, Dogra S. Epidemiology of childhood vitiligo: A study of 625 patients from north India. Pediatr Dermatol 2003;20:207-10. |
|5.||Cho S, Kang HC, Hahm JH. Characteristics of vitiligo in Korean children. Pediatr Dermatol 2000;17:189-93. |
|6.||Belliappa PR, Priya KS, Umashankar N et al. Characteristics of childhood vitiligo in Bangalore with special reference to associated ocular abnormalities. E-J Indian Soc Teledermatology 2011;4:3. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1], [Table 2], [Table 3], [Table 4]