To The Editor,
Few surveyed practitioners provide medical intervention for vitiligo in the Netherlands.1 In a recent United Kingdom qualitative patient survey, patients reported that their physicians had low awareness of the disease and available treatments, dismissing the disease as cosmetic.2 There is evidence that in Saudi Arabia and India, there is a greater focus on therapy.3,4 Little is known about pediatric dermatology practitioner attitudes and management of vitiligo.
A survey was designed by the Pediatric Dermatology Research Alliance (PeDRA) Skin of Color Focus Group investigators, reviewed by the PeDRA surveys committee, and received an exemption from the Mount Sinai Health Systems IRB.
Fifty-six of 107 eligible pediatric dermatologists completed the survey. Forty-four had been in practice for more than 5 years. Practitioners reported seeing an average of 8 pediatric and adolescent patients with vitiligo per month. The majority practiced in the US (n=45, 80.4%) and Mexico (n=6, 10.7%) and 48 were board-certified pediatric dermatologists; Providers surveyed reported feeling most comfortable treating older patients 13-17 (n=48, 85.7%), 5-8 (n=40, 71.4%), 2-4 years of age (n=18, 32.1%), less comfortable with toddlers and infants 13-23 (n=12, 21.4%), 7-12 (n=4, 7.1%), and 0-6 months (n=1, 1.7%) respectively. Quality of life (QoL) was assessed by interview (n=50, 89.3%), psychiatric screening (n=14, 25%), and QoL scores (n=11, 19.6%). Bloodwork was performed infrequently with full thyroid panels (n=38, 67.8%) and 25-OH vitamin D levels (n=27, 48.2%) being the most common labs.
Indicators of rapid color loss were thought to be ongoing color loss (n=49, 88%), acral location (n=33, 58.9%), greater than 25% depigmentation (n=32, 57.1%), and lesional poliosis (n=29, 51.7%). Greater than 50% color-loss (n=54, 96.4%), acral location (n=47, 83.9%), and prolonged disease course (n=42, 75%) were
