Genital vitiligo in children: Factors associated with generalized, non-segmental vitiligo.
Administration, Topical
Adrenal Cortex Hormones
/ administration & dosage
Biopsy
Calcineurin Inhibitors
/ administration & dosage
Calcitriol
/ administration & dosage
Child
Child, Preschool
Dermatologic Agents
/ administration & dosage
Diagnosis, Differential
Female
Genitalia
/ pathology
Humans
Male
Retrospective Studies
Sex Factors
Vitiligo
/ drug therapy
pediatrics
vitiligo
Journal
Pediatric dermatology
ISSN: 1525-1470
Titre abrégé: Pediatr Dermatol
Pays: United States
ID NLM: 8406799
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
pubmed:
5
11
2019
medline:
15
12
2020
entrez:
5
11
2019
Statut:
ppublish
Résumé
It remains uncertain as to whether genital vitiligo of childhood is segmental or a forme fruste of non-segmental disease. This type of vitiligo is sometimes termed figure-of-eight disease due to female predominance and perineal and perianal hypopigmentation or depigmentation around two orifices, the anal and vaginal introitus. The objective of this series was to categorize the features of genital-limited vitiligo of childhood including comorbidities, family history, and long-term course. IRB-approved retrospective chart review of vitiligo cases. Eight cases of vitiligo that began in childhood in the genital area were identified, including clinical course and comorbidities. Involvement of the contiguous skin, including inner thighs, buttocks, and scrotum, was noted in all males. In females, only 1 patient had other sites of vitiligo, which was a solitary lesion on the chest. Therapeutic response to topical corticosteroids for perianal skin was seen in five of six children and topical calcineurin inhibitors with or without calcipotriene in four out of four patients. Segmental disease limited to the genitalia was more common in females than males, suggesting that perhaps intervention and work-up for comorbid autoimmune diseases may be required for males with genital-limited vitiligo at onset, but may be deferred in females and added if observation of spread is noted. Differentiation from lichen sclerosus et atrophicus may require biopsy.
Sections du résumé
BACKGROUND/OBJECTIVES
OBJECTIVE
It remains uncertain as to whether genital vitiligo of childhood is segmental or a forme fruste of non-segmental disease. This type of vitiligo is sometimes termed figure-of-eight disease due to female predominance and perineal and perianal hypopigmentation or depigmentation around two orifices, the anal and vaginal introitus. The objective of this series was to categorize the features of genital-limited vitiligo of childhood including comorbidities, family history, and long-term course.
METHODS
METHODS
IRB-approved retrospective chart review of vitiligo cases.
RESULTS
RESULTS
Eight cases of vitiligo that began in childhood in the genital area were identified, including clinical course and comorbidities. Involvement of the contiguous skin, including inner thighs, buttocks, and scrotum, was noted in all males. In females, only 1 patient had other sites of vitiligo, which was a solitary lesion on the chest. Therapeutic response to topical corticosteroids for perianal skin was seen in five of six children and topical calcineurin inhibitors with or without calcipotriene in four out of four patients.
CONCLUSIONS
CONCLUSIONS
Segmental disease limited to the genitalia was more common in females than males, suggesting that perhaps intervention and work-up for comorbid autoimmune diseases may be required for males with genital-limited vitiligo at onset, but may be deferred in females and added if observation of spread is noted. Differentiation from lichen sclerosus et atrophicus may require biopsy.
Substances chimiques
Adrenal Cortex Hormones
0
Calcineurin Inhibitors
0
Dermatologic Agents
0
calcipotriene
143NQ3779B
Calcitriol
FXC9231JVH
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
64-68Informations de copyright
© 2019 Wiley Periodicals, Inc.
Références
Silverberg NB. The epidemiology of vitiligo. Curr Dermatol Rep. 2015;4:36-43.
Halder RM, Grimes PE, Cowan CA, Enterline JA, Chakrabarti SG, Kenney JA Jr. Childhood vitiligo. J Am Acad Dermatol. 1987;16:948-954.
Silverberg JI, Silverberg NB. Topical tacrolimus is more effective for treatment of vitiligo in patients of skin of color. J Drugs Dermatol. 2011;10:507-510.
Ezzedine K, Lim HW, Suzuki T, et al. Revised classification/nomenclature of vitiligo and related issues: the Vitiligo Global Issues Consensus Conference. Pigment Cell Melanoma Res. 2012;25:E1-E13.
Pagovich OE, Silverberg JI, Freilich E, Silverberg NB. Thyroid abnormalities in pediatric patients with vitiligo in New York City. Cutis. 2008;81:463-466.
Silverberg N. Segmental vitiligo may not be associated with risk of autoimmune thyroiditis. Skinmed. 2011;9:329-330.
Hann SK, Lee HJ. Segmental vitiligo: clinical findings in 208 patients. J Am Acad Dermatol. 1996;35:671-674.
Koga M, Tango T. Clinical features and course of type A and type B vitiligo. Br J Dermatol. 1988;223-228.
Dennin MH, Stein SL, Rosenblatt AE. Vitiligoid variant of lichen sclerosus in young girls with darker skin types. Pediatr Dermatol. 2018;35:198-201.
Weisberg EL, Le LQ, Cohen JB. A case of simultaneously occurring lichen sclerosus and segmental vitiligo: connecting the underlying autoimmune pathogenesis. Int J Dermatol. 2008;47:1053-1055.
Ezzedine K, Diallo A, Leaute-Labreze C, et al. Halo naevi and leukotrichia are strong predictors of the passage to mixed vitiligo in a subgroup of segmental vitiligo. Br J Dermatol. 2012;166:39-44.
Khaitan BK, Kathuria S, Ramam M. A descriptive study to characterize segmental vitiligo. Indian J Dermatol Venereol Leprol. 2012;78:715-721.
Mulekar SV, Al Issa A, Al Eisa A, et al. Genital vitiligo treated by autologous, noncultured melanocyte-keratinocyte cell transplantation. Dermatol Surg. 2005;31:1737-1739.
Grau C, Silverberg NB. Vitiligo patients seeking depigmentation therapy: a case report and guidelines for psychological screening. Cutis. 2013;91:248-252.
Taieb A, Morice-Picard F, Jouary T, et al. Segmental vitiligo as the possible expression of cutaneous somatic mosaicism: implications for common non-segmental vitiligo. Pigment Cell Melanoma Res. 2008;21:646-652.
Van Geel NA, Mollet IG, De Schepper S, et al. First histopathological and immunophenotypic analysis of early dynamic events in a patient with segmental vitiligo associated with halo nevi. Pigment Cell Melanoma Res. 2010;23:375-384.
Mazereeuw-Hautier J, Bezio S, Mahe E, et al. Segmental and nonsegmental childhood vitiligo has distinct clinical characteristics: a prospective observational study. J Am Acad Dermatol. 2010;62:945-949.