Clinical Spectrum of Pediatric Hypopigmentary Disorders with Special Emphasis on Childhood Vitiligo: A Cross-Sectional Study

Abstract

Background: Hypopigmentary disorders constitute the majority of pigmentary dermatoses encountered in pediatric dermatology. Although most are benign, these disorders frequently cause cosmetic concerns, psychological distress, and anxiety among parents. Childhood vitiligo represents one of the most important acquired hypopigmentary disorders because of its chronic course and significant psychosocial impact.

Objective: To evaluate the clinical spectrum of pediatric hypopigmentary disorders with special emphasis on the demographic profile, clinical characteristics, and disease pattern of childhood vitiligo.

Materials and Methods: A hospital-based cross-sectional study was conducted among children aged 0–15 years presenting with hypopigmentary disorders to the Department of Dermatology, Venereology and Leprosy, Vijayanagara Institute of Medical Sciences, Ballari, Karnataka, between January and December 2021. Clinical history, demographic characteristics, lesion morphology, anatomical distribution, associated findings, and relevant investigations were recorded. Data were analyzed using SPSS version 25.0.

Results: Among 200 children with pigmentary disorders, 163 (81.5%) had hypopigmentary disorders. Vitiligo was the most common hypopigmentary disorder (38.7%), followed by pityriasis alba (30.7%), nevus depigmentosus (11.0%), pityriasis versicolor (8.0%), and post-inflammatory hypopigmentation (6.1%). Most hypopigmentary disorders occurred in the 11–15-year age group with a slight female predominance. Among children with vitiligo, the 6–10-year age group was most commonly affected, while mucosal involvement and Koebner phenomenon were observed in a minority of cases.

Conclusion: Hypopigmentary disorders constitute the predominant pigmentary disorders in children, with vitiligo representing the leading diagnosis. Recognition of characteristic clinical patterns facilitates early diagnosis, appropriate treatment, and effective counseling of patients and their caregivers.