Study Highlights the Need to Expand Awareness About the Incidence of Vitiligo in the Pediatric Patient Population

Literature reveals that vitiligo can significantly affect a patient’s overall well-being and health-related quality of life and is often correlated with other chronic autoimmune conditions such as alopecia areata, thyroid disease, diabetes mellitus, RA, IBS, atopic dermatitis, psoriasis, etc.¹ As the number of individuals diagnosed with autoimmune conditions increases, some experts speculate that the number of cases of vitiligo may also rise, so there is a need to expand awareness about the risk factors, clinical presentation and optimal approaches for treating vitiligo including the recent approval of topical ruxolitinib (Opzelura) cream 1.5% marking the first and only FDA-approved treatment for repigmentation in non-immunocompromised adults and pediatric patients 12 years and older for the treatment of nonsegmental vitiligo.

In a recent publication in Dermatology, researchers conducted a cross-sectional, population-based survey between December 30, 2019, and March 11, 2020, involving children aged 4 to 11 years and adolescents between 12 and 17 years. Parent/legal guardian representatives completed survey questions for vitiligo screening on behalf of their children or adolescents. The researchers sought to approximate the “point prevalence” of both diagnosed and undiagnosed vitiligo, including the two primary forms: segmental and non-segmental vitiligo in children and adolescents. The estimated point prevalence was computed for both “proxy reported and clinician-adjudicated vitiligo.”

The authors wrote, “There have been no recent studies conducted to estimate the point prevalence of vitiligo in the general population of children and adolescents in the US. The prevalence of vitiligo among these two age groups will be useful to understand their disease burden and to inform the need for development of new therapies. In addition, as treatment modalities can vary for SV and NSV, prevalence estimates by vitiligo subtype will also be useful.”

The results revealed that 9,118 proxy responses were received, including (5,209 children with an average age of 7.7 years and 3,909 adolescents with an average age of 14.4 years). The authors also revealed that the proxy-reported vitiligo prevalence for children and adolescents was recorded as 1.52% and 2.16%, respectively, and that an estimated 69% and 65% of children and adolescents, respectively, had nonsegmental vitiligo and as much as 50% of these patients may be undiagnosed. The clinician-verified prevalence was reported as 0.84% and 1.19%, respectively.²

Based on their findings, the authors wrote, “Based on the clinician-adjudicated prevalence estimates, there were more than 591,000 cases of vitiligo in children and adolescents in the US in 2020. More than two-thirds had nonsegmental vitiligo, and nearly half may be undiagnosed. Future studies should confirm these findings.”

Conclusion

The findings from this study reveal that up to 50% of children and adolescents with vitiligo remained undiagnosed, which highlights the need to expand awareness about this dermatological condition, the two most common types, the need for early diagnosis and clinical intervention to improve clinical outcomes and patient HRQoL as well as the efficacy and safety of the recently approved targeted therapy, Opzelura (ruxolitinib) cream 1.5% for eligible pediatric patients 12 years and older with nonsegmental vitiligo and the need for therapies for younger patients.

References

Gandhi K, Ezzedine K, Anastassopoulos KP, Patel R, Sikirica V, Daniel SR, Napatalung L, Yamaguchi Y, Baik R, Pandya AG. Prevalence of vitiligo among adults in the United States. JAMA Dermatol. 2022;158(1):43-50. doi: 10.1001/jamadermatol.2021.4724

Patel R, Pandya AG, Sikirica V, Gandhi K, Daniel SR, Anastassopoulos KP, Yamaguchi Y, Napatalung L, Baik R, Ezzedine K. Prevalence of vitiligo among children and adolescents in the United States. Dermatology. 2023;239(2):227-234. doi 10.1159/000528180