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- Presentation
Vitiligo Update by Pr Khaled Ezzedine
Description
In his update on vitiligo, Pr. Khaled Ezzedine discusses the current state of research, epidemiology, and treatment options for this skin condition, which results in loss of skin pigmentation. Despite limited approved treatments, the prevalence of vitiligo is substantial, particularly among children and adolescents, with significant numbers remaining undiagnosed. A systematic review was conducted to assess the global incidence and prevalence, revealing a worldwide prevalence of 0.24% in children. Ezzedine emphasizes the importance of accurate diagnosis and differentiating between non-segmental and segmental vitiligo, noting the differing prognoses and treatment approaches. He highlights the clinical challenges, including misdiagnosis and the psychological impact of vitiligo on affected individuals, especially adolescents. Treatments discussed include topical calcineurin inhibitors and recent innovations like JAK inhibitors, with emphasis on the importance of prolonged therapy to prevent recurrences. He also recommends considering patient and parent perspectives in treatment decisions and underscores the need for ongoing research to improve therapeutic strategies. Overall, the talk provides comprehensive insights into the complexities of diagnosing and managing vitiligo, aiming to improve outcomes for patients.
View moreConclusions
- The prevalence of vitiligo in adolescents in the US was found to be 2.16%, indicating significant representation among this demographic.
- Approximately 600,000 children and adolescents in the US are estimated to be affected by vitiligo, with more than two-thirds having non-segmental vitiligo.
- A substantial portion, nearly half, of pediatric vitiligo cases may go undiagnosed, highlighting a critical gap in detection and treatment.
- The research identified key differences between segmental and non-segmental vitiligo, with varying implications for prognosis and treatment strategies.
- High rates of associated conditions like halo nevi and a positive family history suggest a genetic or familial component to vitiligo in children.
- The study emphasizes the importance of accurate diagnosis through clinical assessment and potential teledermatology applications for remote consultation.
- Prolonged treatment is necessary due to high relapse rates, and there is a pressing need for more approved therapeutic options for this condition, particularly in the pediatric population.
- Topical calcineurin inhibitors were identified as a preferred first-line treatment for vitiligo in children and adolescents, with careful management of potential side effects.
- Dermatology 2023;239:227-234
- DOI: 10.1159/000528180
- Ezzedine K, Silverberg N. A Practical Approach to the Diagnosis and Treatment of Vitiligo in Children. Pediatrics. 2016 Jul;138(1):e20154126. doi: 10.1542/peds.2015-4126.
- Ezzedine K et al. Pre- vs.post-pubertal onset of vitiligo: multivariate analysis indicates association in pre-pubertal onset vitiligo. Br J Dermatol. 2012;167:490-5
- Renert-Yuval Y, Ezzedine K, Grimes P, Rosmarin D, Eichenfield LF, Castelo-Soccio L, Huang V, Desai SR, Walsh S, Silverberg JI, Paller AS, Rodrigues M, Weingarten M, Narla S, Gardner J, Siegel M, Ibad S, Silverberg NB. Expert Recommendations on Use of Topical Therapeutics for Vitiligo in Pediatric, Adolescent, and Young Adult Patients. JAMA Dermatol.
- Bae JM et al. Combination therapy with 308-nm excimer laser, topical tacrolimus, and short-term systemic corticosteroids for segmental vitiligo: a retrospective study of 159 patients. J Am Acad Dermatol 2015