Treatment of vitiligo in children
Kseniia K. Kadanina , Kira Y. Kruchkova , Konstantin M. Lomonosov
Russian Journal of Skin and Venereal Diseases ›› 2024, Vol. 27 ›› Issue (5) : 583 -590.
Treatment of vitiligo in children
Vitiligo is an idiopathic disease of skin hypopigmentation that affects between 0.2% and 8% of the world's population. In half of the cases, this hypomelanosis manifests in young adolescence and childhood and can lead to profound psychological trauma and deterioration of the quality of life of both the child and his/her parents. Patients with vitiligo experience shame, anxiety and even depression, leading to low self-esteem and social isolation. Negative experience can affect not only childhood development, but also the further adult life of the patient, in this regard, the actual problem is the selection of effective and safe therapy in this cohort of patients. In the arsenal of doctors there are many therapeutic and surgical methods used in the treatment of this disease. However, not all therapies can be used in paediatric patients, which creates a challenge for paediatric dermatologists.
This review presents current, effective, and safe treatments for vitiligo in paediatric patients. Thus, external calcineurin inhibitors are first-line therapy, especially in children with stable vitiligo and limited lesions on the face, neck and body folds with thin skin. External glucocorticoid agents are recommended for moderate activity. Topical Janus kinase inhibitors provide the best results in the facial area. Demonstrated their effectiveness in achieving repigmentation in children with widespread and progressive vitiligo UVB-311 nm therapy, therapy with ultraviolet excimer light, PUVA-therapy (psoralen together with long-wave ultraviolet skin irradiation). Therapy with systemic corticosteroids can stop the progression of the disease and stimulate the repigmentation process. Surgical treatment (transplantation of melanocytes from healthy skin foci to depigmented foci) is rarely used in children. Cosmetic agents (camouflage) are used as symptomatic treatment, and psychological support is used as cognitive therapy.
Childhood vitiligo should be detected early to improve treatment outcomes and prognosis. Early detection of new exacerbations will allow rapid therapeutic intervention to prevent widespread spread of the disease.
glucocorticosteroids / pediatric vitiligo / psychotherapy / systemic therapy / UVB therapy / phototherapy / surgical methods
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