Indian Journal of Paediatric Dermatology

LETTER TO EDITOR
Year
: 2017  |  Volume : 18  |  Issue : 4  |  Page : 351--352

Ocular abnormalities in childhood vitiligo - when to screen?


Manish K Shah 
 Department of Pediatric Dermatology, Wadia Hospital for Children, Mumbai, Maharashtra, India

Correspondence Address:
Manish K Shah
Flat No. 192, Enterprise Apartments, Forjett Hill Road, Tardeo, Mumbai - 400 026, Maharashtra
India




How to cite this article:
Shah MK. Ocular abnormalities in childhood vitiligo - when to screen?.Indian J Paediatr Dermatol 2017;18:351-352


How to cite this URL:
Shah MK. Ocular abnormalities in childhood vitiligo - when to screen?. Indian J Paediatr Dermatol [serial online] 2017 [cited 2019 Jul 21 ];18:351-352
Available from: http://www.ijpd.in/text.asp?2017/18/4/351/215793


Full Text



When evaluating patients with vitiligo, one hardly ever seeks ophthalmology opinion. In this issue, Raju and Nagraju[1] have reported clinical features and ocular findings of 180 children with vitiligo in South India.

Childhood vitiligo most frequently starts on the face, especially eyelids and lower limbs. Focal and segmental vitiligo tend to occur more frequently in children as compared to adults.[2],[3] Though vitiligo vulgaris is the most common type of vitiligo seen in children, less than 5% body surface area tends to be involved in 85.6–96.4% of children.[3],[4],[5]

Ocular abnormalities have been described in conjunction with vitiligo vulgaris. The presence of periorbital vitiligo is significantly associated with ocular findings.[6] The article in this issue has similar inferences. Depigmented spots in the iris, lamellar cataract, and persistent papillary membrane were noted in the 38 children studied by Bulbul et al.[6] The clinical relevance of these findings is unclear. These findings became evident on ocular examination and it does not seem likely that any of these children had any impairment of visual acuity.

In 223 patients of all age groups, 27% of the patients had some evidence of retinal pigment hypopigmentation and one patient had retinitis pigmentosa. Four percent of patients in a control group had similar fundoscopic findings (P< 0.001).[7]

Considering the incidence of vitiligo, the number of cases with ocular involvement appears to be sparse. It seems to be prudent to get an ophthalmology opinion when a child has vitiligo in the periorbital region. Given the medicolegal implications, this would be important as baseline documentation prior to starting phototherapy or applying topical steroids around the eyes.

References

1Raju BP, Nagaraju U. Profile of childhood vitiligo with associated ocular abnormalities in south India. Ind J Pediatr Dermatol 2016;17:179-85.
2Nicolaidou E, Antoniou C, Miniati A, Lagogianni E, Matekovits A, Stratigos A, et al. Childhood- and later-onset vitiligo have diverse epidemiologic and clinical characteristics. J Am Acad Dermatol 2012;66:954-8.
3Kanwar AJ, Dhar S, Kaur S. Vitiligo in children. Ind J Dermatol 1993;38:47-52.
4Jain M, Jain SK, Kumar R, Mehta P, Banjara N, Kalwaniya S, et al. Clinical profile of childhood vitiligo patients in Hadoti region in Rajasthan. Indian J Paediatr Dermatol 2014;15:20-3.
5Handa S, Dogra S. Epidemiology of childhood vitiligo: A study of 625 patients from north India. Pediatr Dermatol 2003;20:207-10.
6Bulbul Baskan E, Baykara M, Ercan I, Tunali S, Yucel A. Vitiligo and ocular findings: A study on possible associations. J Eur Acad Dermatol Venereol 2006;20:829-33.
7Albert DM, Wagoner MD, Pruett RC, Nordlund JJ, Lerner AB. Vitiligo and disorders of the retinal pigment epithelium. Br J Ophthalmol 1983;67:153-6.