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TOPLINE:
METHODOLOGY:
- While half of all vitiligo cases manifest within the initial two decades of life, no guidelines specifically address the management of vitiligo in children, adolescents, and young adults with vitiligo.
- A protocol was established to formulate consensus recommendations addressing questions related to pediatric vitiligo.
- Overall, 50 articles on topical corticosteroids and/or topical calcineurin inhibitors, five on topical Janus kinase inhibitors, and two each on pseudocatalase and microdermabrasion were included.
- The participants recorded their agreement levels with the formulated statements, using a 5-point Likert scale.
TAKEAWAY:
- TCIs, TCSs, JAK inhibitors, and phototherapy, specifically narrowband ultraviolet (UV)-B light therapy, are mainstay treatments; the combination of UV-B light and topical therapy may enhance initial repigmentation.
- Long-term monitoring for skin cancers is advised, and short outdoor UV exposure is suggested for pediatric patients.
- TCIs, such as tacrolimus and pimecrolimus, are recommended as first-line therapy, particularly on the face, applied twice daily for ≥ 3 months; continued use for 6-12 additional months is recommended if repigmentation is observed.
- The choice of TCS class depends on the site and planned usage duration. Short-term use or overlap with TCIs is recommended because of the risk for atrophy with long-term TCS use. Class 5-6 agents are another option.
- For areas with thin skin, TCSs can be considered second-line treatments.
- Topical JAK inhibitors, specifically topical 1.5% ruxolitinib cream, are recommended for patients aged ≥ 12 years, as first- or second-line therapy. Limitation to 10% body surface area is recommended to minimize systemic absorption. Limited evidence exists for children aged < 12 years.
IN PRACTICE:
“Effective therapy requires a focus on long-term therapeutic interventions to maximize the local gain and retention of pigmentation with a trial period of twice-weekly application. Counseling should include discussion of the chronicity of vitiligo and the need for long-term care,” the authors wrote.
LIMITATIONS:
Some of the recommendations were opinion-based because of the scarcity of evidence-based literature.
SOURCE:
The consensus statement was published on March 13 in JAMA Dermatology.
DISCLOSURES:
This work was supported by grants from Vitiligo Research Foundation and Incyte Pharmaceuticals. The majority of authors disclosed financial relationships outside this work; several reported no disclosures.
A version of this article appeared on Medscape.com.
TOPLINE:
METHODOLOGY:
- While half of all vitiligo cases manifest within the initial two decades of life, no guidelines specifically address the management of vitiligo in children, adolescents, and young adults with vitiligo.
- A protocol was established to formulate consensus recommendations addressing questions related to pediatric vitiligo.
- Overall, 50 articles on topical corticosteroids and/or topical calcineurin inhibitors, five on topical Janus kinase inhibitors, and two each on pseudocatalase and microdermabrasion were included.
- The participants recorded their agreement levels with the formulated statements, using a 5-point Likert scale.
TAKEAWAY:
- TCIs, TCSs, JAK inhibitors, and phototherapy, specifically narrowband ultraviolet (UV)-B light therapy, are mainstay treatments; the combination of UV-B light and topical therapy may enhance initial repigmentation.
- Long-term monitoring for skin cancers is advised, and short outdoor UV exposure is suggested for pediatric patients.
- TCIs, such as tacrolimus and pimecrolimus, are recommended as first-line therapy, particularly on the face, applied twice daily for ≥ 3 months; continued use for 6-12 additional months is recommended if repigmentation is observed.
- The choice of TCS class depends on the site and planned usage duration. Short-term use or overlap with TCIs is recommended because of the risk for atrophy with long-term TCS use. Class 5-6 agents are another option.
- For areas with thin skin, TCSs can be considered second-line treatments.
- Topical JAK inhibitors, specifically topical 1.5% ruxolitinib cream, are recommended for patients aged ≥ 12 years, as first- or second-line therapy. Limitation to 10% body surface area is recommended to minimize systemic absorption. Limited evidence exists for children aged < 12 years.
IN PRACTICE:
“Effective therapy requires a focus on long-term therapeutic interventions to maximize the local gain and retention of pigmentation with a trial period of twice-weekly application. Counseling should include discussion of the chronicity of vitiligo and the need for long-term care,” the authors wrote.
LIMITATIONS:
Some of the recommendations were opinion-based because of the scarcity of evidence-based literature.
SOURCE:
The consensus statement was published on March 13 in JAMA Dermatology.
DISCLOSURES:
This work was supported by grants from Vitiligo Research Foundation and Incyte Pharmaceuticals. The majority of authors disclosed financial relationships outside this work; several reported no disclosures.
A version of this article appeared on Medscape.com.
TOPLINE:
METHODOLOGY:
- While half of all vitiligo cases manifest within the initial two decades of life, no guidelines specifically address the management of vitiligo in children, adolescents, and young adults with vitiligo.
- A protocol was established to formulate consensus recommendations addressing questions related to pediatric vitiligo.
- Overall, 50 articles on topical corticosteroids and/or topical calcineurin inhibitors, five on topical Janus kinase inhibitors, and two each on pseudocatalase and microdermabrasion were included.
- The participants recorded their agreement levels with the formulated statements, using a 5-point Likert scale.
TAKEAWAY:
- TCIs, TCSs, JAK inhibitors, and phototherapy, specifically narrowband ultraviolet (UV)-B light therapy, are mainstay treatments; the combination of UV-B light and topical therapy may enhance initial repigmentation.
- Long-term monitoring for skin cancers is advised, and short outdoor UV exposure is suggested for pediatric patients.
- TCIs, such as tacrolimus and pimecrolimus, are recommended as first-line therapy, particularly on the face, applied twice daily for ≥ 3 months; continued use for 6-12 additional months is recommended if repigmentation is observed.
- The choice of TCS class depends on the site and planned usage duration. Short-term use or overlap with TCIs is recommended because of the risk for atrophy with long-term TCS use. Class 5-6 agents are another option.
- For areas with thin skin, TCSs can be considered second-line treatments.
- Topical JAK inhibitors, specifically topical 1.5% ruxolitinib cream, are recommended for patients aged ≥ 12 years, as first- or second-line therapy. Limitation to 10% body surface area is recommended to minimize systemic absorption. Limited evidence exists for children aged < 12 years.
IN PRACTICE:
“Effective therapy requires a focus on long-term therapeutic interventions to maximize the local gain and retention of pigmentation with a trial period of twice-weekly application. Counseling should include discussion of the chronicity of vitiligo and the need for long-term care,” the authors wrote.
LIMITATIONS:
Some of the recommendations were opinion-based because of the scarcity of evidence-based literature.
SOURCE:
The consensus statement was published on March 13 in JAMA Dermatology.
DISCLOSURES:
This work was supported by grants from Vitiligo Research Foundation and Incyte Pharmaceuticals. The majority of authors disclosed financial relationships outside this work; several reported no disclosures.
A version of this article appeared on Medscape.com.