Indian Journal of Paediatric Dermatology

ORIGINAL ARTICLE
Year
: 2016  |  Volume : 17  |  Issue : 2  |  Page : 101--103

A clinico-epidemiological study on childhood vitiligo


Neerja Puri 
 Department of Dermatologist, Punjab Health Systems Corporation, Mohali, Punjab, India

Correspondence Address:
Neerja Puri
House No. 626, Phase II, Urban Estate, Dugri Road, Ludhiana, Punjab
India

Abstract

Introduction: Vitiligo is a disorder of melanocytes which may have a significant effect on the psyche of a patient. Aims: To study the clinical profile of the patients with childhood vitiligo and see the association of vitiligo with other autoimmune diseases. Methods: A randomized controlled prospective study was done of thirty patients of childhood vitiligo aged below14 years of age. Results: Vitiligo vulgaris was the most common type of vitiligo seen in 50% children followed by focal and segmental vitiligo in 20% each followed by acrofacial vitiligo in 10% children.



How to cite this article:
Puri N. A clinico-epidemiological study on childhood vitiligo.Indian J Paediatr Dermatol 2016;17:101-103


How to cite this URL:
Puri N. A clinico-epidemiological study on childhood vitiligo. Indian J Paediatr Dermatol [serial online] 2016 [cited 2020 Feb 23 ];17:101-103
Available from: http://www.ijpd.in/text.asp?2016/17/2/101/179410


Full Text

 Introduction



Vitiligo is an acquired hypomelanotic disorder of the skin resulting from loss of functional melanoctyes.[1] Vitiligo may considerably influence a patient's health related quality of life and psychological well-being.

Aims

To study the clinical profile of the patients with childhood vitiligo and see the association of vitiligo with other autoimmune diseases.

 Methods



A randomized controlled prospective study was done of thirty patients of childhood vitiligo aged below 14 years of age.

 Results



There were 18 female children and 12 male children in our study and female: male was 1.5:1. Maximum number of children (50%) had vitiligo between 10 and 20 years of age, 30% between 6 and 10 years of age, and 20% between 0 and 5 years of age. Sixty percent of patients had duration of vitiligo <5 years, 30% between 1 and 5 years and 10% children had duration <10 years. The mean age of onset of vitiligo was 7.4 years. Leukotrichia was seen in 6 (20%) patients. Halo nevi were seen in 3 (10%) children. Vitiligo vulgaris was the most common type of vitiligo seen in 50% children followed by focal and segmental vitiligo [Figure 1] in 20% each followed by acrofacial vitiligo [Figure 2] in 10% children. There was no significant association with dietary habits in vitiligo. Physical trauma was the most common precipitating factor in vitiligo seen in 20% patients. Vitiligo due to footwear, postburns, and emotional stress were seen in 10% patients each. The most common site of involvement was face and neck and legs (30% each) followed by trunk (10%) and arms and mucosal involvement in 10% each. Regarding association of vitiligo with other autoimmune diseases, hypothyroidism was seen in 50% children, autoimmune thyroiditis, alopecia areata, and atopic dermatitis were seen in 10% children each and psoriasis and premature greying of hairs were seen in 3.3% each. In our study, positive family history was seen in 20% patients.{Figure 1}{Figure 2}

Disease can be localized, segmental, or generalized the latter starting as acrofacial disease in many patients with gradual extension. Generalized disease is bilaterally symmetrical, affecting the joints, the periorificial areas, intertriginous sites, and the distal tips of the digits.[2] Segmental disease appears to follow a variety of embryonic segments ranging from the lines of Blaschko to branchial clefts on the face. This form is more common in children, is often accompanied by loss of pigment in the hairs, and rarely generalizes. Children with vitiligo often have relatives with autoimmune diseases (mostly of the thyroid). Children with a family history of autoimmunity or leukotrichia develop vitiligo earlier than children with no family history of disease. About half of all the vitiligo vulgaris patients have onset of illness during childhood.

In our study, female exceeded males which was in accordance with studies by Kovacs et al.[3] This is because of the social stigma attached more to a girl child with vitiligo compared to a boy and hence the female children are reported earlier by their parents. In our study, 60% patients had duration of disease more than 5 years and duration varied from 6 months to 8 years. Similar studies had been performed by Howitz et al.[4] A positive family was reported in 22% cases in our study. Handa and Kaur [5] and Kanwar [6] reported positive family history in 11.5% patients. This is attributed to the role of genetic factors in the pathogenesis of vitiligo.

 Conclusion



In our study, vitiligo vulgaris was the most common subtype with female preponderance. Research on the presence of autoimmune disease particularly thyroid disorder is of great interest. Although not life threatening, vitiligo may considerably influence a patient's health-related quality of life and psychological well-being. In the management of adult and pediatric vitiligo alike, it is essential that the dermatologist establish a relationship with each patient as well as keep patients informed about therapeutic options and their effectiveness. Vitiligo can have psychosocial effects in the pediatric population. The epidemiology of pediatric vitiligo generally is similar to adult vitiligo, with a few important differences. Although in adults there is no gender predilection for vitiligo, in the pediatric population, vitiligo seems to occur more frequently in females. Pediatric and adult vitiligo differs. The most notable difference is the increased prevalence of segmental vitiligo, the most difficult type of vitiligo to treat, in the pediatric population. Other significant differences include a predilection for females, increased family history of vitiligo and koebnerization in pediatric patients.

Declaration of Patient Consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.

References

1Kent G, Al'Abadie M. Psychologic effects of vitiligo: A critical incident analysis. J Am Acad Dermatol 1996;35:895-8.
2Kanwar AJ, Dhar S, Dawn G. Oral minipulse therapy in vitiligo. Dermatology 1995;190:251-2.
3Kovacs SO. Vitiligo. J Am Acad Dermatol 1998;38(5 Pt 1):647-66.
4Howitz J, Brodthagen H, Schwartz M, Thomsen K. Prevalence of vitiligo. Epidemiological survey on the Isle of Bornholm, Denmark. Arch Dermatol 1977;113:47-52.
5Handa S, Kaur I. Vitiligo: Clinical findings in 1436 patients. J Am Acad Dermatol 1999;26:653-7.
6Kanwar AJ, Dhar S, Kaur S. Vitiligo in children. Ind J Dermatol 1993;38:47-52.