Clinical repigmentation patterns in paediatric vitiligo

Br J Dermatol. 2016 Sep;175(3):555-60. doi: 10.1111/bjd.14635. Epub 2016 Aug 6.

Abstract

Background: Repigmentation is an essential outcome measure in vitiligo. However, clinical studies describing vitiligo repigmentation patterns are lacking.

Objectives: To assess and clearly define the repigmentation patterns in a series of patients with vitiligo, correlating these with clinicoepidemiological characteristics.

Methods: Patients with vitiligo seen at least at twice (initial consultation and follow-up visit) in the Department of Paediatric Dermatology, Hôpital Pellegrin des Enfants, Bordeaux University Hospital from 2006 to 2014 were included. Clinical photographs and case records were reviewed.

Results: There were 109 patients (64 female, 45 male) mostly with Fitzpatrick skin type III (n = 67, 61%). The majority had nonsegmental (n = 71, 65%) or segmental vitiligo (n = 29, 27%). In total 172 representative vitiligo lesions were analysed. Overall, a combined pattern of repigmentation was most commonly seen (n = 106, 62%). The combined pattern occurred more frequently in patients with segmental vs. nonsegmental vitiligo (P = 0·009), whereas the diffuse pattern was more frequent in the latter (P = 0·007). Diffuse repigmentation was the predominant pattern on the eyelids (P < 0·001). We observed a new pattern in sites with few to absent hair follicles, which we propose to call 'medium spotted repigmentation'. This begins as circular macules of repigmentation, wider than 5 mm in diameter, which, from the outset, are larger than the initial macules of perifollicular repigmentation. This study is limited by its retrospective nature and small sample size for subgroup assessment.

Conclusions: The combined pattern of repigmentation was most frequently observed. Medium spotted repigmentation is a new pattern, which will benefit from larger studies for a better understanding.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Dermatologic Agents / therapeutic use
  • Eyelid Diseases / pathology
  • Eyelid Diseases / therapy
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Infant
  • Male
  • Prednisone / therapeutic use
  • Skin Pigmentation*
  • Ultraviolet Therapy
  • Vitiligo / pathology*
  • Vitiligo / therapy

Substances

  • Dermatologic Agents
  • Glucocorticoids
  • Prednisone