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Childhood Vitiligo in China

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Childhood Vitiligo in China

Abstract and Introduction

Abstract


Background: Childhood vitiligo is a common pediatric skin disorder. The pathogenesis of vitiligo is unclear, and immunological dysfunction may play an important role.
Objectives: This prospective study aimed to profile childhood vitiligo and to discuss its correlation with immunological dysfunction.
Methods: All of the 620 enrolled patients were aged younger than 14 years, and were assessed with a standard questionnaire. The levels of immunoglobulins, complement, and T-lymphocyte subsets were measured in 270 of these 620 patients.
Results: Of the 620 children, 302 (48.71%) were boys and 318 (51.29%) were girls, with an average disease onset age of 7.57 years. The average duration was 13.45 months. 453 (73.06%) children had head and neck involvement and 160 (25.81%) children had segmental vitiligo. 84 (13.55%) children had a family history. There was a correlation between the disease and seasons. The onset or progression usually occurred in summer and spring. Halo nevus was seen in both segmental and non-segmental vitiligo. Precipitating factors such as stress appeared more commonly in segmental vitiligo. As to the immunological findings, in segmental vitiligo, the levels of C3 and C4 were lower in the active relative to the quiescent stage (p < 0.05); and in non-segmental vitiligo, the percentages of CD3+ and CD4+ lymphocytes and the CD4+/CD8+ ratio were lower in the active relative to the quiescent stage (p < 0.01).
Conclusions: Childhood vitiligo has its own clinical features. The different types of vitiligo have different characteristics. There is immunological dysfunction in children with vitiligo. Dysfunction of humoral immunity may play a role in the progression of segmental vitiligo, while non-segmental vitiligo is more related to cellular immunity.

Introduction


Vitiligo is one of the most common skin pigmentary disorders. Approximately 1%of the world's population is affected by this disease. Childhood vitiligo is an important pediatric skin disease. Its clinical features are different from those of adults, for example, there is a higher incidence in girls, a higher proportion of segmental vitiligo, a higher probability of having autoimmune diseases in relatives, and a better response to treatment. Therefore, it has been considered that childhood vitiligo is a distinct subset of vitiligo.

The pathogenesis of vitiligo is still unclear. It has been attributed to autoimmune, genetic, and neuromediated aberrations, and so on. Childhood vitiligo may have a tremendous impact on the psychological development of children.

This study aims to profile the clinical characteristics of childhood vitiligo, the levels of certain basic parameters for cellular and humoral immunity, and reveal their correlations with disease activity in order to lay an immunopathogenetic basis for further studies.

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