Compared to segmental vitiligo, nonsegmental vitiligo in pediatric patients was associated with a higher number of lesions and a larger body surface area of involvement. There was a higher incidence of the Koebner phenomenon in nonsegmental vitiligo and more frequent progression of the disease. Thyroid abnormalities and a hyperpigmented rim around vitiligo lesions were observed only in nonsegmental vitiligo.Vitiligo is an acquired disorder characterized by a progressive loss of melanocytes.1 The exact prevalence in the pediatric age group is unknown. Available epidemiologic data indicate that approximately 25% of patients had onset of their vitiligo before 10 years of age.2Capsule Summary
Vitiligo is traditionally divided into two distinct clinical forms: nonsegmental vitiligo (NSV) and segmental vitiligo (SV). SV occurs in a minority of patients and is thought to be more frequent in pediatric patients.3, 4, 5 There are limited data regarding the comparative clinical characteristics of SV and NSV. It has been suggested that thyroid abnormalities are more frequent in patients with NSV as compared to patients with SV.6, 7, 8, 9, 10, 11, 12, 13 No clinical study has been performed to assess the clinical differences between SV and NSV. The aim of this study was to compare the clinical features of SV and NSV in children.
This was designed as a prospective observational study. Consecutive children with vitiligo, seen in the 11 French Departments of Pediatric Dermatology (Angers, Amiens, Bordeaux, Dijon, Nantes, Nice, Quimper, Reims, Toulouse, and two Departments in Paris) between October 2005 and December 2007, were included. Vitiligo was defined clinically as acquired depigmented lesions, after exclusion of other differential diagnoses.
For each patient, a standardized evaluation, including a full clinical
A total of 114 patients with vitiligo were included. There were 61 (54%) girls and 53 (46%) boys (sex ratio M/F: 0.87). The age of patients at inclusion was 8.3 years ± 0.7 (mean ± standard error [SE]); range, 0.25-15 years. Of the 114 patients, 25 (22%) had SV and 89 (78%) had NSV. The patients' characteristics according to vitiligo subtype are displayed in Table II and can be summarized as follows:
This epidemiological study of childhood vitiligo identified significant differences in clinical characteristics and evolution between SV and NSV. NSV was associated with a higher number of lesions and a larger body surface area of involvement. In NSV, we showed a higher incidence of the Koebner phenomenon and a more frequent progression of the disease within 1 year. In addition, thyroid abnormalities and hyperpigmented rims around the patches of depigmentation were seen exclusively in NSV.
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The prevalence of these other diseases is very low. Antinuclear antibodies may be found in children with vitiligo, but not in segmental forms.13 This is considered a marker of the general autoimmune status of the child with vitiligo.
Funding sources: None.
Conflicts of interest: None declared.
