Author(s): Belliappa Pemmanda Raju1, Priya Kootelu2, Umashankar Nagaraju3, Leena Raveendra4, Vivekananda5, Lokanatha Keshavulu6
Vitiligo is an acquired depigmentary disorder, where approximately 50% of the cases have the onset of their disease prior to the age of 20 years and 25% prior to the age of 14 years. There is limited data on the clinical characteristics including associated cutaneous and ocular abnormalities in childhood vitiligo.
To evaluate the various clinical characteristics and associated cutaneous and ocular abnormalities of childhood vitiligo.
In a prospective, hospital based study over a period of two years; the epidemiology of childhood vitiligo was studied including associated cutaneous and ocular abnormalities.
Of the total 122 children studied, majority of them were females (n=75, 61.5%), and the rest males (n=47, 38.5%). The mean age of presentation was 8 years. Progression of lesions was present in 36 children (29.5%). The most common site of initial lesion was head and neck followed by lower limbs, genitalia, trunk and upper limbs. Eight children (6.6%) had a history of trauma prior to onset of vitiligo. Eighteen children (14.8%) had a family history of vitiligo. The most common type was vitiligo vulgaris seen in 45 children (36.9%) followed by segmental type in 33 children (27%). Leukotrichia was seen in 51 children (41.8%), while Koebner phenomenon was observed in 30 children (24.6%). Fifteen children (12.3%) had an associated cutaneous disorder. These associated disorders were halo nevi in 6 children (4.9%), alopecia areata in 3 children (2.5%), canities in 2 children (1.6%), and cafe au lait macule, nevus depigmentosus, lichen nitidus, lichen striatus in 1 each (0.8%). Thirty children (24.6%) had an associated ocular disorder. These associated disorders were eyelid vitiligo in 26 children (21.3%), depigmented spots in the iris in 2 patients (1.6%), lamellar cataract and persistent papillary membrane in 1 each (0.8%).
Childhood vitiligo in Bangalore showed preponderance in females and greater number of children (72.4%) present with depigmentation in the age group of 7 to 12 years. Majority of patients (77.9%) had less than 5% body surface area involvement. Low incidence of ocular pigmentary abnormalities in comparison with adult population might suggest that childhood vitiligo patients do not have ocular pigmentary abnormalities in the beginning, but as they age or as the disease progresses they may develop ocular pigmentary changes.