High-potency steroid use in children with vitiligo: a retrospective study.

Abstract

Data on efficacy and safety of treatments in children with vitiligo are limited. We sought to describe the clinical outcomes and safety of children with vitiligo treated with high-potency topical corticosteroids. Clinical improvement and laboratory data were retrospectively analyzed in 101 children (0-18 years) with vitiligo treated with moderate- to high-potency topical corticosteroids. Of patients, 64% (45 of 70) had repigmentation of the lesions, 24% (17 of 70) showed no change, and 11% (8 of 70) were worse than at the initial presentation. Local steroid side effects were noted in 26% of patients at 81.7 +/- 44 days of follow-up. Cortisol levels were abnormal in 29% of patients (21 of 73). Two children with low cortisol levels were given the diagnosis of steroid-induced adrenal suppression. Children with normal and abnormal cortisol levels were not significantly different by sex, age of onset, potency of the corticosteroid use, or family history. However, children with head and/or neck affected areas were 8.36 times more likely to have an abnormal cortisol level compared with children affected in other body areas (RR 95% confidence interval: 1.19, 58.60, P = .003, n = 72). Of patients, 8% (6 of 74) had an abnormal thyrotropin test result. The retrospective design of this study presents inherent limitations. Moderate- to high-potency topical corticosteroids are efficacious in children with vitiligo, but may be associated with systemic absorption.