The Pediatric Dermatologist’s View of Pediatric Vitiligo

February 2024 | Volume 23 | Issue 2 | e77 | Copyright © February 2024


Published online January 24, 2024

Mark Weingarten MDa, Michelle Schwartz MDb, Candrice Heath MDc, Nanette B. Silverberg MDa

aDepartment of Dermatology, Mount Sinai Medical Center, New York, NY
bDepartment of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
cDepartment of Dermatology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA



poor prognostic indicators in the opinion of survey participants. Topical calcineurin inhibitors (TCI), topical corticosteroids (TCS), Narrowband UVB, coverup makeup, topical JAK inhibitors (tJAKi), and 308-nm laser were the leading vitiligo therapeutics chosen (Table 2). Clinical photographs, measurement of lesion size (n=48 each, 85.7%), subjective patient-reported satisfaction (n=41, 73.2%), and percent re-pigmentation (n=34, 60.7%) were used most for disease monitoring. VASI scores (n=3, 5.3%), BSA (n=3, 5.3% and mobile device apps (n=1, 1.8%) were uncommonly used. Practitioners almost universally reported occasional to constant frustration in the care for pediatric vitiligo due to a lack of treatment options and insurance barriers (94.5%). Most (77.2%) reported always or often experiencing challenges in procuring appropriate therapies. Parental phobia of topical corticosteroid use in pediatric patients was noted to occur occasionally (n=29, 51.8%) to frequently (n=10, 17.8%). 

TCI and TCS were favored for non-segmental and segmental vitiligo, with NB-UVB, excimer laser, tJAKi, and cosmetic cover-up being used consistently, but less frequently. Systemic agent usage was very limited. Barriers to the therapy of vitiligo identified by pediatric dermatologists include poor access to therapeutics, reduced comfort in treating children under 2 years of age, and parental anxiety. The publication of long-term safety data and an authoritative guideline to streamline diagnosis and treatment are warranted.  

DISCLOSURES

Nanette Silverberg, MD has been a speaker and advisor for Astellas, and Incyte. Dr Schwartz and Mr Weingarten both report no conflicts of interest.
IRB: Pediatric Dermatology Research Alliance Approved IRB.

REFERENCES

  1. Njoo MD, Bossuyt PM, Westerhof W. Management of vitiligo. Results of a questionnaire among dermatologists in The Netherlands. Int J Dermatol. 1999;38(11):866-872. doi:10.1046/j.1365-4362.1999.00822.x 
  2. Teasdale E, Muller I, Abdullah Sani A, et al. Views and experiences of seeking information and help for vitiligo: a qualitative study of written accounts. BMJ Open. 2018;8(1):e018652. doi:10.1136/bmjopen-2017-018652 
  3. Ismail SA, Sayed DS, Abdelghani LN. Vitiligo management strategy in Jeddah, Saudi Arabia as reported by dermatologists and experienced by patients. J Dermatolog Treat. 2014;25(3):205-211. doi:10.3109/09546634.20 12.762638 
  4. Chatterjee M, Das A. Management of vitiligo amidst the COVID-19 pandemic: a survey and resulting consensus. Indian J Dermatol. 2021;66(5):479-483. doi:10.4103/ijd.ijd_859_20

AUTHOR CORRESPONDENCE

Nanette Silverberg MD Nanette.silverberg@mountsinai.or
Close Menu