Main Article Content
Abstract
BACKGROUND
Vitiligo is an acquired primary, usually progressive, melanocytopenia of unknown aetiology clinically manifested by circumscribed achromic macules and histologically by degeneration and disappearance of melanocytes in involved skin. Childhood vitiligo deserves special attention as it has unique epidemiological features. We wanted to determine, compare and analyze the clinical and epidemiological features and autoimmune disease associations in childhood vitiligo and adult vitiligo.
METHODS
It was a prospective cross-sectional observational hospital-based clinical study conducted in a suburban medical college hospital over 20 months which involved 120 patients with vitiligo who were assessed using detailed history and clinical examination for demographic and clinical data. Relevant history and family history were noted. Investigations including complete hemogram, serum biochemistry profile, thyroid profile and fasting plasma glucose examination were performed in all patients. Data were collected, tabulated, and all statistical analysis was done by using SPSS trial version 25 and in MS Excel 2007.
RESULTS
The majority of patients were in the age group of 16-30 years. Among 60 patients, female preponderance was noted in the study with a percentage of 53.3 % followed by 46 % males in the childhood group. The prevalence of segmental vitiligo was more in children (30 %) than in adults (5 %) which was statistically significant (P= 0.000). In adults, there was a statistically significant higher prevalence (P=0.000) of mucosal vitiligo (30 %) than in children (3.35 %). On performing statistical analysis, thyroid dysfunction (P=0.00) and diabetes mellitus (P=0.01) were found to be significantly more prevalent in adults than in children.
CONCLUSIONS
This study provides clinical evidence that vitiligo at different ages has different characteristics mainly regarding an increased incidence of segmental vitiligo and a more common positive family history among children than adults. A higher prevalence of thyroid dysfunction and diabetes mellitus in adult vitiligo patients compared to children warrants prompt treatment in all detected cases to prevent long-term morbidity and complications.
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References
- Anstey AV. Disorders of skin colour. In: Burns T, Breathnach S, Cox N, Griffiths C, eds. Rook's textbook of dermatology. 8th edn. Oxford: Wiley-Blackwell 2010:58.1-58.59.
- Birlea SA, Spritz RA, Norris DA. Disorders of melanocytes. In: Goldsmith LA, Katz SI, Gilchrest BA, et al, eds. Fitzpatrick’s dermatology in general medicine. 8th edn. New York: McGraw Hill 2013:792-803.
- Prasad D, Kumaran SM. Depigmentary and hypopigmentary disorders. In: Sacchidanand S, Oberai C, Inamdar AC, eds. Indian association of dermatology and venereology text book of dermatology. 4th edn. Mumbai: Bhalani Publishing House 2015:1295-326.
- Ortonne JP. Vitiligo and other disorders of hypopigmentation. In: Bolognia JL, Jorizzo JL, Rapini RP, eds. Bolognia dermatology. 2ndedn. Mosby Elsevier 2008: p. 65.
- Iacovelli P, Sinagra JLM, Vidolin AP, et al. Relevance of thyroiditis and of other autoimmune diseases in children with vitiligo. Dermatology 2005;210(1):26-30.
- Pajvani U, Ahmad N, Wiley A, et al. The relationship between family medical history and childhood vitiligo. J Am Acad Dermatol 2006;55(2):238-44.
- Jain M, Jain SK, Kumar R, et al. Clinical profile of childhood vitiligo patients in Hadoti region in Rajasthan. Indian J Paediatr Dermatol 2014;15(1):20-3.
- Sheth PK, Sacchidanand S, Asha GS. Clinico-epidemiological profile of childhood vitiligo. Indian J Paediatr Dermatol 2015;16(1):23-8.
- Prakash P, Thappa DM. A clinical study of the spectrum of vitiligo in children versus adults and its associations. Indian Dermatol Online J 2013;4(3):250-1.
- Agarwal G. Vitiligo: an under - estimated problem. Fam Pract 1998;15 Suppl 1:S19-23.
- Prcic S, Djuran V, Mikov A, et al. Vitiligo in children. Pediatr Dermatol 2007;24(6):666.
- Hann SK, Park YK, Chun WH. Clinical feature of vitiligo. Clin Dermatol 1997;15(6):891-7.
- Gopal KVT, Rao GR, Kumar YH. Increased prevalence of thyroid dysfunction and diabetes mellitus in Indian vitiligo patients: a case control study. Indian Dermatol Online J 2014;5(4):456-60.
- Zettinig G, Tanew A, Fischer G, et al. Autoimmune diseases in vitiligo: do anti-nuclear antibodies decrease thyroid volume? Clin Exper Immunol 2003;131(2):347-54.
- Alkhateeb A, Fain PR, Thody A, et al. Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Res 2003;16(3):208-14.
- Huggins RH, Janniger CK, Schwartz RA. Vitiligo. Acta Dermatovenerol Alp Panonica Adriat 2005;14:137-45.
- Schallreuter KU, Lemke R, Brandt O, et al. Vitiligo and other diseases: coexistence of true association? Hamburg study on 321 patients. Dermatology 1994;188(4):269-75.
- Narita T, Oiso N, Fukai K, et al. Generalized vitiligo and associated autoimmune disease in Japanese patients and their families. Allergol Int 2011;60(4):505-8.
- Dave S, Thappa DM, Dsouza M. Clinical predictors of outcome in vitiligo. Indian J Dermatol Venereol Leprol 2002;68(6):323-5.
References
Anstey AV. Disorders of skin colour. In: Burns T, Breathnach S, Cox N, Griffiths C, eds. Rook's textbook of dermatology. 8th edn. Oxford: Wiley-Blackwell 2010:58.1-58.59.
Birlea SA, Spritz RA, Norris DA. Disorders of melanocytes. In: Goldsmith LA, Katz SI, Gilchrest BA, et al, eds. Fitzpatrick’s dermatology in general medicine. 8th edn. New York: McGraw Hill 2013:792-803.
Prasad D, Kumaran SM. Depigmentary and hypopigmentary disorders. In: Sacchidanand S, Oberai C, Inamdar AC, eds. Indian association of dermatology and venereology text book of dermatology. 4th edn. Mumbai: Bhalani Publishing House 2015:1295-326.
Ortonne JP. Vitiligo and other disorders of hypopigmentation. In: Bolognia JL, Jorizzo JL, Rapini RP, eds. Bolognia dermatology. 2ndedn. Mosby Elsevier 2008: p. 65.
Iacovelli P, Sinagra JLM, Vidolin AP, et al. Relevance of thyroiditis and of other autoimmune diseases in children with vitiligo. Dermatology 2005;210(1):26-30.
Pajvani U, Ahmad N, Wiley A, et al. The relationship between family medical history and childhood vitiligo. J Am Acad Dermatol 2006;55(2):238-44.
Jain M, Jain SK, Kumar R, et al. Clinical profile of childhood vitiligo patients in Hadoti region in Rajasthan. Indian J Paediatr Dermatol 2014;15(1):20-3.
Sheth PK, Sacchidanand S, Asha GS. Clinico-epidemiological profile of childhood vitiligo. Indian J Paediatr Dermatol 2015;16(1):23-8.
Prakash P, Thappa DM. A clinical study of the spectrum of vitiligo in children versus adults and its associations. Indian Dermatol Online J 2013;4(3):250-1.
Agarwal G. Vitiligo: an under - estimated problem. Fam Pract 1998;15 Suppl 1:S19-23.
Prcic S, Djuran V, Mikov A, et al. Vitiligo in children. Pediatr Dermatol 2007;24(6):666.
Hann SK, Park YK, Chun WH. Clinical feature of vitiligo. Clin Dermatol 1997;15(6):891-7.
Gopal KVT, Rao GR, Kumar YH. Increased prevalence of thyroid dysfunction and diabetes mellitus in Indian vitiligo patients: a case control study. Indian Dermatol Online J 2014;5(4):456-60.
Zettinig G, Tanew A, Fischer G, et al. Autoimmune diseases in vitiligo: do anti-nuclear antibodies decrease thyroid volume? Clin Exper Immunol 2003;131(2):347-54.
Alkhateeb A, Fain PR, Thody A, et al. Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Res 2003;16(3):208-14.
Huggins RH, Janniger CK, Schwartz RA. Vitiligo. Acta Dermatovenerol Alp Panonica Adriat 2005;14:137-45.
Schallreuter KU, Lemke R, Brandt O, et al. Vitiligo and other diseases: coexistence of true association? Hamburg study on 321 patients. Dermatology 1994;188(4):269-75.
Narita T, Oiso N, Fukai K, et al. Generalized vitiligo and associated autoimmune disease in Japanese patients and their families. Allergol Int 2011;60(4):505-8.
Dave S, Thappa DM, Dsouza M. Clinical predictors of outcome in vitiligo. Indian J Dermatol Venereol Leprol 2002;68(6):323-5.