Introduction

Vitiligo is an acquired disorder characterised by progressive loss of functional melanocytes resulting in depigmented skin and hair.

Epidemiology

Its prevalence in the general population varies between 0- 2.16% worldwide with one third to one half having their onset in childhood.^(1,2) Childhood vitiligo (CV), defined as disease onset before the age of 12 years, is common. In India 2% of children attending a pediatric clinic were diagnosed with vitiligo.⁽³⁾ The childhood cases of vitiligo, with an age of onset less than or equal to 12 years are typically associated with more halo nevi, Koebner phenomenon, positive family history, segmental disease and personal history of atopy. Those with late onset of more than 12 years are associated with more acrofacial lesions and thyroid disease.⁽⁴⁾ Even though disease onset in less than two years is unlikely as opposed to congenital disorders of pigmentation, the disease onset increases through the first two decades.⁽⁵⁾ Onset before age 2 years represents 11% of pediatric-onset cases, 28% of cases start between 2 and 5 years, 40% of cases begin between 5 and 10 years, and 21% between 10 and 18 years, demonstrating that median age of onset is between 5 and 10 years of age.⁽⁶⁾ The prevalence of vitiligo by gender is usually close to if not equal, with some studies supporting female predilection in the youngest age groups.⁽⁴⁾ In a cohort of 268 Indian children 12 years and younger, 56.7% were girls (n = 152) and 43.3% were boys (n = 116). The breakdown of vitiligo types in a pediatric population varies by population reviewed. In a case series of 119 pediatric patients with vitiligo, 34% had generalized disease, 13% acrofacial, 3% mucosal, 29% segmental, and 21% undetermined. Lower estimates of segmental disease include 17.6% of cases in children who were 12 years or younger in an Indian cohort.⁽⁷⁾

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Himang Jharaik

Obstetrics & Gynaecology Deptt, Civil Hospital Theog, District Shimla 171201. Himachal Pradesh, India