title: Pharmacologic Treatment of Vitiligo in Children and Adolescents: A Systematic Review.
abstract: BACKGROUND
  The true pathogenic mechanism of vitiligo is still unknown. About half of the patients with this disease have onset before the age of 20 years, making it a serious dermatologic disorder in childhood.
  
  
  OBJECTIVE
  The objective of this study was to review the literature in a systematic way and identify the main pharmacologic treatments and outcomes in children and adolescents with vitiligo.
  
  
  METHODS
  Four databases-the National Library of Medicine (MEDLINE-PubMed), Web of Science, Scopus, and Latin American and Caribbean Health Sciences (LILACS)-were used for the search up to January 2015. All electronic search titles, selected abstracts and full-text articles were independently reviewed by a minimum of two reviewers.
  
  
  RESULTS
  There were 15 articles from 13 different countries: 3 were retrospective and 12 were prospective; the number of participants in the studies varied between 9 and 400, ages ranged from 0 to 18 years, and the duration of disease ranged from 1 to 17 years. The most commonly used drugs were tacrolimus alone (or combined with clobetasol), pimecrolimus, corticosteroids, and calcipotriol. Treatment duration ranged from 10 days to 6 months with a topical route of administration.
  
  
  CONCLUSIONS
  The main outcome measurements were morphometric analysis performed using a computer program, hematologic or biochemical change, and photography (predominant). It is unclear which was the most effective treatment for vitiligo, however, it was found that these therapies are all promising in the treatment of the disease. With proper care, disease control and repigmentation, even if partial, can be achieved.
authors.affiliation: Núcleo de Pós-Graduação em Medicina, Universidade Federal de Sergipe-UFS, Aracaju, SE, Brazil.
authors.forename: Andreia Freire
authors.initials: AF
authors.lastname: de Menezes
authors.affiliation: Núcleo de Pós-Graduação em Medicina, Universidade Federal de Sergipe-UFS, Aracaju, SE, Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Oliveira de Carvalho
authors.affiliation: Núcleo de Pós-Graduação em Medicina, Universidade Federal de Sergipe-UFS, Aracaju, SE, Brazil.
authors.forename: Rosana S S
authors.initials: RS
authors.lastname: Barreto
authors.affiliation: Núcleo de Pós-Graduação em Medicina, Universidade Federal de Sergipe-UFS, Aracaju, SE, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: de Santana Silva
authors.affiliation: Núcleo de Pós-Graduação em Medicina, Universidade Federal de Sergipe-UFS, Aracaju, SE, Brazil.
authors.forename: Saravanan
authors.initials: S
authors.lastname: Shanmugam
authors.affiliation: Núcleo de Pós-Graduação em Medicina, Universidade Federal de Sergipe-UFS, Aracaju, SE, Brazil.
authors.forename: Ricardo Queiroz
authors.initials: RQ
authors.lastname: Gurgel
authors.affiliation: Núcleo de Pós-Graduação em Medicina, Universidade Federal de Sergipe-UFS, Aracaju, SE, Brazil.
authors.forename: Adriano Antunes
authors.initials: AA
authors.lastname: de Souza Araújo
mesh_terms: D000293:Adolescent; D002117:Calcitriol / Q000031:analogs & derivatives / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002990:Clobetasol / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016559:Tacrolimus / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome; D014820:Vitiligo / Q000188:drug therapy*
chemical_list: D003879:Dermatologic Agents; D005938:Glucocorticoids; C055085:calcipotriene; C117268:pimecrolimus; D002990:Clobetasol; D002117:Calcitriol; D016559:Tacrolimus