Let’s talk with our expert dermatologists and pediatricians about vitiligo in children.
As we have already said several times in this thematic site, vitiligo is defined as an autoimmune disease of the skin characterized by the appearance of spots that are lighter than the color of the skin. This skin depigmentation often occurs before pubertal age and in any case by the age of 20.
It is a disease directed against the melanocytes of the skin. Melanocytes are responsible for the production of melanin, which gives the skin its color.
We know that there is a genetic predisposition in Vitiligo and that the triggers are still unknown. It has an incidence of 1-2% and is familiar in 1/3 of cases. Vitiligo can be associated with other autoimmune diseases, such as Hashimoto’s thyroiditis, diabetes, celiac disease, polyendocrinopathies, connective tissue diseases.
Vitiligo children, let’s now see how it is detected.
How to spot it
Vitiligo in children manifests itself with white spots on the skin with convex and clear edges and with a different shape and size in each case. Usually the parts most affected are those exposed to the sun such as the face, arms and legs.
In some cases it can also be associated with lightening of the hair, hair and eyelashes. Based on the extension we can classify the pathology in this way.
- Local form: when it involves a localized area or a little more
- Segmentary: when it extends over a part of the child’s body, such as an entire limb or half of the back
- Generalized it extends on two sides more or less in a symmetrical manner
The most common form of pediatric vitiligo is the segmental form, where the spots are asymmetrical and progress rapidly over 1-2 years in the affected area and then stabilize.
In childhood vitiligo, initial pictures are observed mainly characterized by lesions limited to the corners of the mouth (87.4%) and to the eyelids, to the genital areas (86%) and to the prominent areas such as elbows, knees and ankles, back of the fingers ( 92.1%) and feet, more exposed to microtrauma.
Vitiligo in children how it is diagnosed
Vitiligo in children is diagnosed based on the child’s medical history and physical examination, detailed with Wood’s light. It is a type of lamp that emits ultraviolet rays, to be used in the dark, and which highlights the white color of the vitiligo lesions.
Speaking of vitiligo in children, Koebner’s sign is often evident, with the appearance of lesions even after minor trauma, especially in the summer months when the skin is not covered by clothing.
Specific laboratory tests are performed only if symptoms of other autoimmune diseases are associated. Such as excessive weight loss, fatigue, heartbeat, joint pain.
In pediatric age, pityriasis alba and tuberous sclerosis also enter into differential diagnosis with these patches. Or even cicatricial results of insect bites and achromic nevus, which are well differentiated through the Wood’s light used by the dermatologist and which correctly distinguishes the extent of total depigmentation of the skin even on fair skin.
Among the treatments of choice, UV ray micro-phototherapy is also indicated for pediatric vitiligo.
Curated by Dr. Rocchi Alessia and Dr. Marina Fantato
