| Background:Vitiligo is a common pigment loss disease with a global incidence rate of about1%,with research statistics that about 40% of patients develop before age 12.Vitiligo skin lesions,especially in exposed areas,have a great influence on appearance,which can seriously affect the daily life of patients,such as social,study and work,and children’s psychology is not mature,more vulnerable to psychological damage,so it is particularly important to study the treatment of vitiligo in children.Objective:A retrospective analysis of children with vitiligo from January 2012 to December 2018 in the dermatology department of the first Hospital of Jilin University was carried out to summarize its clinical characteristics and efficacy,in order to provide a certain reference for the treatment of vitiligo in children.Method:Retrospective study.patient inclusion criteria :1 definite diagnosis of vitiligo;2age ≤ 12;3 treatment or follow-up ≥ 12 months.Exclusion criteria: those who failed to record the curative effect on time.record the patient’s basic information,including: name,sex,age,course of disease,site of involvement,area of involvement,classification,stage,time of progression of patients with progression,score of activity of vitiligo disease,involvement of hair mucosa,family history of vitiligo,and combination of autoimmune diseases.The treatment plan was determined according to the patient’s condition,the activity score of vitiligo disease and the consensus of diagnosis and treatment related to vitiligo.the treatments included :1 topical drugs,including calcineurin inhibitors(TCI),glucocorticoids(TCS);2 phototherapy,including311 nm-313 nm narrow-wave UVB(nb-UVB),308 nm excimer laser;3 systemic hormone therapy: oral prednisone(0.2-0.3 mg/kg/d)or dexamethasone microimpact(0.75-2.25 mg 2 consecutive days per week).Each month after the start of treatment,before treatment,each visit by the same person in the same place with the same camera to take pictures of the lesions.Every three months,the patient’s coloration and new hair were recorded to evaluate the curative effect.and assess whether there is a correlation between the efficacy and the basic condition of the patient.The data were analyzed SPSS21.0 statistical software,and the set P< was 0.05.Result:Among the 110 children included in the study,51 were male(46.4%)and 59 were female(53.6%);the mean age was 7.1±3.0 years;the median course was 5months.the affected area :76 cases(69.1%)<1% body surface area;27 cases(24.5%)≥1% and ≤2% body surface area;7 cases(6.4%)>2% and 5% body surface area.staging :104 cases in progression(94.5%)and 6 cases in stabilization(5.5%).Classification :32 cases(29.1%)of segmental type,57 cases(51.8%)of non segmental type,45 cases(78.9%)of sporadic type,10 cases(17.5%)of mucosal extremity type,2 cases(3.5%)of restricted type,19 cases(17.3%)of untypical type and 2 cases(1.8%)of mixed type.Three cases(2.7%)were treated for less than one year;16cases(14.5%)were treated for one year;54 cases(49.1%)were treated > one year and ≤2 years;25 cases(22.7%)were treated >2 years and ≤5 years(8.2%);and 3cases(2.7%)were treated in >5 years.The overall effective rate was 85.4%,the effective rate was 64.5%,the cure rate was 15.5%;the effective rate was 49%,the effective rate was 22.4%,the cure rate was 2.0%;the effective rate was 73.5%,the effective rate was 37.8%,the cure rate was 6.1%;the effective rate was 80.4%,the effective rate was 51%,the cure rate was 10.8%;the effective rate was 85.6%,the effective rate was 61.6%,the cure rate was 13.5%.3.6,9,12 months of efficiency,significant differences in efficiency.The effective rate was 96.9%,the effective rate was 65.6%,the cure rate was 18.8%;the effective rate was 77.2%,the effective rate was 56.1%,the cure rate was 8.8%;the effective rate was 89.5%,the effective ratewas 84.2%,the cure rate was 26.3%.There was statistical difference between segmental type and non-segmental type effective rate(χ2=5.989,Pχ2=0.05),and there was no significant difference between apparent efficiency and cure rate(both P>0.05).the initial disease activity score(VIDA)was positively correlated with the overall polychromatic area(OR=0.303,POR=0.05);the disease progression time was negatively correlated with the overall polychromatic area(OR=-0.245,PPOR=0.013).For segmental type,the effective rate was 94.4%,the effective rate was 66.7%,the cure rate was 22.2%;the effective rate was 100%,the effective rate was 64.3%,the cure rate was 14.3%;the effective rate and effective rate of systemic glucocorticoid group was not statistically different from that of non-system glucocorticoid group(P>0.05).For non-segmental type,the effective rate was 88.9%,the effective rate was 66.7%,the cure rate was 11.1%,the effective rate was 66.7%,the effective rate was 46.7% and the cure rate was 6.7%.The effective rate of systemic glucocorticoid use group was significantly better than that of non-systemic glucocorticoid use group(χ 2=3.986,P χ 2=0.05),and there was no significant difference in significant efficiency and cure rate(P>0.05).Conclusion:1.Childhood segmental vitiligo is more effective than non-segmental vitiligo,which may be related to non-segmental vitiligo’s tendency to repeatedly enter the active stage leading to a decrease in overall evaluation efficacy.2.The activity score(VIDA score)of vitiligo disease at the beginning of visit was positively correlated with the overall color restoration area,and the disease progression time was negatively correlated with the overall color restoration area,suggesting that the earlier vitiligo began treatment,the better the clinical efficacy.3.As for segment vitiligo,there was no significant difference between the effective rate of systemic glucocorticoid use,but as for nonsegmental vitiligo,non-systemic glucocorticoid use in children was significant difference... |
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