Vitiligo na infância: análise das características clínico-epidemiológicas de 701 casos

Abstract

Vitiligo is an acquired pigmentary disorder that affects approximately 0,5% to 2,0% of the world population, and 25% of cases begin before 10 years of age. Although prevalent, there are few studies in Brazilian and world literatures on the characterization of childhood vitiligo. We aimed to evaluate clinical and epidemiological characteristics of childhood vitiligo. It is an observational, retrospective and descriptive study conducted by obtaining data records of patients under the age of 18, in which disease onset occurred before 13 years of age by dermatologists at vitiligo clinic of Instituto de Dermatologia Prof. Rubem David Azulay, Rio de Janeiro from 2006 to 2015. Variables such as gender, clinical type and subtype of vitiligo, age of onset, site of onset, autoimmune associated diseases, emotional stress, autoantibodies, Koebner phenomenon, familial and personal history of autoimmune diseases, presence of halo nevus and stability of the lesions were evaluated . Descriptive analysis of the data was performed, expressed by the frequency, the mean and standard deviation in the total sample, and by types and subtypes of childhood vitiligo. It was also performed to compare the clinical and epidemiological variables between types and subtypes of vitiligo. We have also compared our results with world literature. We found predominance of females (62,0%). The most common subtype was generalized vitiligo (53,8%). The average age of disease onset was 5,9 years. The most affected site of onset was the head/neck segment (44,2%). The Koebner phenomenon was present in 38,2%, emotional stress was present in 67,0% of the patients, halo nevus was present in 17,4% and associated autoimmune disease in 6,7% of the patients. Family history of vitiligo was observed in 16.9% of the patients and stability was reported by 20,1% of patients. The presence of positive family history did not significantly influence the age of onset nor the stability of the lesions. We found a significant difference between segmental vitiligo and non segmental vitiligo regarding the age of onset, Koebner phenomenon, hypothyroidism, anti-TPO antibodies, family history of psoriasis and halo nevus. However, there was no significant difference regarding the stability of the lesions and the presence of emotional triggering factors between the 2 groups. Our results were, in part, similar to those of the world literature. However, there are differences due, theoretically, to regional particularities based on different ethnic/genetic backgrounds. Our study presents a great number of patients, which helps to better elucidate the peculiarities of childhood vitiligo in the Brazilian population.