title: Childhood facial vitiligo: how intractable is it?
abstract: BACKGROUND
  Following the recent elucidation of its pathogenic mechanisms involving reactive oxygen species, use of vitamins, folic acid and antioxidants as adjuvant therapy has been suggested.
  
  
  OBJECTIVE
  To evaluate the long-term outcome of childhood facial vitiligo who were treated with nutritional education, vitamin E (α-tocopherol 100-400 IU/day), folic acid (1-2 mg/day) and multivitamin intake and antioxidant cosmetics as the mainstay of treatment as well as the conventional therapies including oral, topical and/or intralesional corticosteroid, topical macrolactam, Excimer laser and epidermal graft.
  
  
  METHODS
  Medical data and photographs of 111 paediatric facial vitiligo patients who had been followed up for longer than 1 year from March 1, 2003 to June 30, 2013 were extracted from data warehouse of electric medical records. Photographic evaluation and final visual outcome assessment was performed.
  
  
  RESULTS
  By investigator's assessment, 9% of patients demonstrated no improvement regardless of treatment modality, whereas 91% showed improvement of lesions. Among the latter, 33.3% resulted in >75% improvement; 18% in 50%-75% improvement; 26.1% in 25%-50% improvement; and 13.5% in <25% improvement. In the final visual outcome assessment, 'Looking excellent' was seen in 42.3%; 'looking very good' in 30.6%; 'looking good' in 17.1%; 'looking fair' in 9.0%; and 'looking bad' in 0.9%.
  
  
  CONCLUSIONS
  Although childhood facial vitiligo is quite refractory to treatment, the long-term outcome of this condition is not dismal with conventional vitiligo therapy along with basic nutritional therapeutic regimen.
authors.affiliation: Department of Dermatology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeong-gi, Korea.
authors.forename: S A
authors.initials: SA
authors.lastname: Kim
authors.forename: S
authors.initials: S
authors.lastname: Cho
authors.forename: S H
authors.initials: SH
authors.lastname: Kwon
authors.forename: J T
authors.initials: JT
authors.lastname: Park
authors.forename: J I
authors.initials: JI
authors.lastname: Na
authors.forename: C H
authors.initials: CH
authors.lastname: Huh
authors.forename: K C
authors.initials: KC
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004032:Diet; D019587:Dietary Supplements; D005148:Facial Dermatoses / Q000628:therapy*; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D047029:Lactams, Macrocyclic / Q000627:therapeutic use; D054018:Lasers, Excimer / Q000627:therapeutic use; D008297:Male; D009751:Nutritional Requirements; D010353:Patient Education as Topic; D016038:Skin Transplantation; D013997:Time Factors; D016896:Treatment Outcome; D014810:Vitamin E / Q000627:therapeutic use; D014820:Vitiligo / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D000975:Antioxidants; D047029:Lactams, Macrocyclic; D014810:Vitamin E; D005492:Folic Acid