High-potency steroid use in children with vitiligo: A retrospective study - 12/08/11

Doi : 10.1016/j.jaad.2006.08.017

Jennifer Kwinter, BA ^a, Janice Pelletier, MD, FAAP ^b, Amina Khambalia, MSc ^c, Elena Pope, MD, MSc, FRCPC ^c,^⁎
^a From the Faculty of Medicine, University of Ottawa
^b Tufts University School of Medicine
^c Section of Dermatology, Division of Pediatric Medicine, The Hospital for Sick Children and University of Toronto

Reprint requests: Elena Pope, MD, MSc, FRCPC, Section of Dermatology, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8.

Ottawa and Toronto, Ontario, Canada, and Boston, Massachusetts

Abstract

Background

Data on efficacy and safety of treatments in children with vitiligo are limited.

Objective

We sought to describe the clinical outcomes and safety of children with vitiligo treated with high-potency topical corticosteroids.

Methods

Clinical improvement and laboratory data were retrospectively analyzed in 101 children (0-18 years) with vitiligo treated with moderate- to high-potency topical corticosteroids.

Results

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.