TÜRKİYE’DE ÇOCUKLUK ÇAĞI VİTİLİGOLU HASTALARIN KLİNİK VE DEMOGRAFİK ÖZELLİKLERİNİN İNCELENMESİ: PROSPEKTİF, KESİTSEL ÇALIŞMA

AMAÇ: Türkiye’de çocukluk çağı vitiligolu hastaların epidemiyolojisi ile ilgili yapılan çalışma sayısı oldukça azdır. Bu çalışma, Türk toplumundaki çocukluk çağı vitiligolu hastaların demografik ve klinik özelliklerinin prospektif olarak incelemeyi amaçlamıştır. GEREÇ VE YÖNTEM: Bu çalışmaya 2020 yılı içerisinde Deri ve Zührevi Hastalıkları Polikliniğine başvuran 18 yaş altı vitiligosu olan 78 hasta dahil edildi. Hastaların klinik ve demografik özellikleri incelendi. Hastalığın aktifleşme durumu ve eşlik eden kızarıklık, kaşıntı, köbner fenomeni ile tutulum bölgeleri arasında istatistiksel inceleme yapıldı. BULGULAR: Çalışmadaki 78 çocuğun 45’i (%57,7) kız, 33’ü (%43,3) erkekti. Hastalığın ortalama görülme yaşı 7,91 ±4,95 yıldı. Hastaların median vücut tutulum yüzdesi 1 (minimum 1, maksimum 25) idi. Dermatolojiye başvurulduğundaki hastaların yaşı ile hastalık süresi arasında istatistiksel olarak anlamlı korelasyon saptandı (p=0,007, Korelasyon katsayısı=0,313). En sık görülen vitiligo tipi 31 (%39,7) hastada görülen fokalvitiligo iken bunu sırasıyla jeneralize (%37,8), segmental (%14,1) ve akrofasiyalvitiligo (%8,97) izledi. Segmental vitiligo en sık boyunda (%33,3)görülürken sonrasında sırasıyla bacak (%25), kol (%25), yüz (%8,3) ve gövdede (%8,3) görüldü. Akrofasiyal vitiligo kızlarda erkeklere oranla istatistiksel olarak anlamlı ölçüde fazla bulundu (p=0,017). Son iki ay içerisinde baş bölgesinde istatistiksel olarak anlamlı derecede yeni vitiligo lezyon oluşumu ve/ veya mevcut vitiligo lezyonunda büyüme vardı (p=0,007). Köbner fenomeni, vücut yüzey tutulum alanı >%1 olanlarda ≤%1 olanlara göre istatistiksel olarak daha sık saptandı (p=0,009). SONUÇ: Bu çalışmaya göre çocukluk çağı vitiligo en sık 10 yaş altında ortaya çıkmaktadır. Hastalık genel olarak vücut yüzey alanının %1’inden azını tutmaktadır ve köbnerizasyon ile bu oran artma eğilimindedir. Fokal ve jeneralize vitiligo en sık görülen formlardır. Segmental vitiligo en sık boyun bölgesinde görülmektedir. Dermatolojiye başvuru sırasında baş bölgesindeki hastalık aktivitesi diğer bölgelere göre daha yüksektir.

CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF CHILDHOOD VITILIGO IN TURKEY: PROSPECTIVE, CROSS-SECTIONAL STUDY

AIM: Epidemiologic studies that are conducted on childhood vitiligo are quiter are in Turkey. This study aimed to prospectively investigate the demographic and clinical characteristics of patients with childhood vitiligo in a Turkish cohort. MATERIAL AND METHOD: Seventy-eight patients with vitiligo under the age of 18 who applied to the Dermatology and Venereal Diseases Outpatient Clinic in 2020 were included in this study. The clinical and demographic characteristics of the patients were examined. A statistical examination was performed between the activation status of the disease, accompanying redness, itching, Koebner phenomenon and involvement sites. RESULTS: Of the 78 children, 45 (57.7%) were girls and 33 (43.3%) were boys. The mean age of occurrence of the disease was 7.91 ± 4.95 years. The median body involvement percentage of the patients was 1 (minimum 1, maximum 25). A statistically significant correlation was found between the age of the patients and the duration of the disease when presented to dermatology (p = 0.007, correlation coefficient = 0.313). The most common vitiligo type was focal vitiligo in 31 (39.7%) patients, followed by generalized (37.8%), segmental (14.1%) and acrofacial vitiligo (8.97%), respectively. Segmental vitiligo was most commonly seen in the neck (33.3%) followed by leg (25%), arm (25%), face (8.3%), and trunk (8.3%), respectively. Acrofacial vitiligo was statistically significantly higher in girls than in boys (p = 0.017). In the last two months, there was a statistically significant new vitiligo lesion formation and / or enlargement of the existing vitiligo lesion in the head region (p = 0.007). The Kobner phenomenon was statistically more common in those with a body surface involvement > 1% than those with ≤ 1% (p=0.009). CONCLUSION: According to this study, childhood vitiligo frequently occurs in children aged under 10 years old. The disease generally involves less than 1% of the body surface area, and this ratio tends to increase with koebnerization.Focal and generalized vitiligo is the most common forms of childhood vitiligo. Segmental vitiligo is most common in the neck area.During the attending to dermatology, disease activity in the head area is higher than in other areas.

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