[Clinical characteristics, factors associated with disease activity, and thyroid function and (or)autoantibody abnormalities in pediatric patients with vitiligo at a children's hospital in Beijing City from 2017 to 2024].

Objective

To analyze the demographic and clinical characteristics of pediatric patients with vitiligo treated at Beijing Children's Hospital from 2017 to 2024, and to explore factors associated with disease activity and thyroid function and (or) autoantibody abnormalities.

Methods

This was a cross-sectional study. Clinical data of pediatric patients diagnosed with vitiligo in the Department of Dermatology, Beijing Children's Hospital, from January 2017 to December 2024 were retrospectively collected. A total of 2 264 children were analyzed, including 1 204 boys and 1 060 girls, with a male-to-female ratio of 1.14∶1. Clinical differences were compared between the stable-stage group and the active-stage group, and between patients with and without thyroid-related laboratory abnormalities. Univariate analysis and multivariate logistic regression were performed to identify associated factors. For variables with complete separation, Firth bias-reduced logistic regression was applied.

Results

The age at onset ranged from 0.67 to 17.67 years, with a mean of 6.00±3.04 years. Disease duration was 6.00 (2.50, 12.00) months. Nonsegmental vitiligo slightly outnumbered segmental vitiligo [41.61% (942/2 264) vs. 40.90% (926/2 264)], and the progressive stage was the most common disease stage [51.86% (1 174/2 264)]. Initial lesions mainly involved the face and neck (874/2 264, 38.60%), trunk (582/2 264, 25.71%), and scalp (256/2 264, 11.31%). Lesion area was predominantly grade 1 and 2, accounting for 1 584 cases (69.96%) and 624 cases (27.56%), respectively. The most common comorbidities were halo nevus (184/2 264, 8.13%), type 2 inflammatory diseases such as atopic dermatitis (150/2 264, 6.63%), and thyroid diseases (38/2 264, 1.68%). Multivariate analysis showed that shorter disease duration (OR=0.941, 95%CI: 0.929-0.953, P<0.001) was independently associated with active disease; compared with segmental vitiligo, patients with mixed/undetermined type were less likely to be in the active stage (OR=0.398, 95%CI: 0.237-0.669, P<0.001). Thyroid-related laboratory abnormalities were identified in 122 patients (5.39%). Older age at first visit (OR=1.146, 95%CI: 1.056-1.242, P=0.001) and comorbidities (OR=1.812, 95%CI: 1.041-3.155, P=0.036) were independently associated with thyroid-related laboratory abnormalities.

Conclusion

Childhood vitiligo predominantly begins during the preschool and school-age periods and occurs more frequently in spring and summer. Shorter disease duration indicates a higher likelihood of active disease, whereas older age and comorbidities are associated with thyroid-related laboratory abnormalities.