271例儿童白癜风患者的临床特点及危险因素分析
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摘要
目的:探讨儿童白癜风的临床特点及易患白癜风的危险因素,为临床个体化干预治疗提供依据。方法:就诊于本院皮肤科门诊的1 040例白癜风患者分为儿童组271例(年龄≤12岁)和成人组769例(年龄>18岁)。通过标准化的体格检查及问卷调查的方式收集数据,并对其临床特点及危险因素进行分析。结果:271例儿童白癜风患者中,男女比例约为1∶1,与成人组比较差异无统计学意义(P>0.05)。儿童组和成人组高发季节均为春夏季。儿童组中节段型及限局型白癜风的比例明显高于成人组(P<0.05),而散发型、泛发型和肢端型白癜风比例则低于成人组(P<0.05)。诱发因素方面,儿童组以皮肤病及外伤为主(14.76%和13.28%),成人组以精神因素居多(29.39%)。儿童组伴发晕痣的比例明显高于成人组(P<0.05),儿童组患儿白癜风家族史阳性者所占比例与成人组比较差异无统计学意义(P>0.05)。结论:儿童白癜风临床特征与成人比较有一定差异。儿童易患白癜风的危险因素主要为皮肤病、外伤和晕痣。
Objective:To explore the clinical characteristics and the risk factors of vitiligo in children,and to provide basis for the personalized invention treatment in clinic.Methods:A total of 1 040 patients with vitiligo treated in our hospital were divided into children group(n=271,age≤12years)and adult group(n=769,age>18years);physical examination and a standardized questionnaire were used to collect the data and the clinical characteristics and the risk factors were analyzed.Results:In 271 children patients with vitiligo,the ratio of male to female was about 1∶1,there was no significant difference compared with adult group(P>0.05).The high season of vitiligo in children and adult groups were spring and summer.The ratios of segmental vitiligo and focal vitiligo in children group were siginificantly higher than those in adult group(P<0.05);the incidence of sporadic type,generalized type and acral type in children group was lower than that in adult group(P<0.05).The most common precipitating factors of vitiligo in children group were dermatosis and trauma(14.76%,13.28%),but the psychological factors were the most common precipitating factors in adult group(29.39%).The incidence of halo nevi in children group was higher than that in adult group(P<0.05).There was no significant difference in the percentages of the patients with positive family history of vitiligo between children and adult groups(P>0.05).Conclusion:There are some differences in clinical characteristics of vitiligo between the children and the adults.Dermatosis,trauma and halo nevi are the major risk factors of vitiligo in the children.
Objective:To explore the clinical characteristics and the risk factors of vitiligo in children,and to provide basis for the personalized invention treatment in clinic.Methods:A total of 1 040 patients with vitiligo treated in our hospital were divided into children group(n=271,age≤12years)and adult group(n=769,age>18years);physical examination and a standardized questionnaire were used to collect the data and the clinical characteristics and the risk factors were analyzed.Results:In 271 children patients with vitiligo,the ratio of male to female was about 1∶1,there was no significant difference compared with adult group(P>0.05).The high season of vitiligo in children and adult groups were spring and summer.The ratios of segmental vitiligo and focal vitiligo in children group were siginificantly higher than those in adult group(P<0.05);the incidence of sporadic type,generalized type and acral type in children group was lower than that in adult group(P<0.05).The most common precipitating factors of vitiligo in children group were dermatosis and trauma(14.76%,13.28%),but the psychological factors were the most common precipitating factors in adult group(29.39%).The incidence of halo nevi in children group was higher than that in adult group(P<0.05).There was no significant difference in the percentages of the patients with positive family history of vitiligo between children and adult groups(P>0.05).Conclusion:There are some differences in clinical characteristics of vitiligo between the children and the adults.Dermatosis,trauma and halo nevi are the major risk factors of vitiligo in the children.
引文
[1]Ezzedine K,Silverberg N.A practical approach to the diagnosis and treatment of vitiligo in Children[J].Pediatrics,2016,138(1):1-12.
[2]葛宏松,曹婷婷,张成,等.儿童白癜风371例临床特点分析[J].安徽医学,2013,34(9):1306-1308.
[3]Agarwal S,Gupta S,Ojha A,et al.Childhood vitiligo:Clinicoepidemiologic profile of 268children from the Kumaun region of uttarakhand,India[J].Pediatr Dermatol,2013,30(3):348-353.
[4]Silverberg JI,Silverberg B.Quality of life impairment in children and adolescents with vitiligo[J].Pediatr Dermatol,2014,31(3):309-318.
[5]Krüger C,Panske A,Schallreuter KU,et al.Disease-related behavioral patterns and experiences affect quality of life in children and adolescents with vitiligo[J].Int J Dermatol,2014,53(1):43-50.
[6]中国中西医结合学会皮肤性病专业委员会色素病学组.白癜风临床分型及疗效标准(2003修订稿)[J].中华皮肤科杂志,2004,37(7):440.
[7]黄博,许爱娥,卢良君,等.儿童白癜风396例临床分析[J].中华皮肤科杂志,2008,41(4):234-236.
[8]康元,张峻岭,史先花,等.儿童白癜风和成人白癜风分析比较[J].临床皮肤科杂志,2013,42(8):454-457.
[9]Lin X,Tang LY,Fu WW,et al.Childhood vitiligo in China:clinical profiles and immunological findings in 620cases[J].Am J Clin Dermatol,2011,12(4):277-281.
[10]Zhang XJ,Liu JB,Gui JP,et al.Characteristics of genetic epidemiology and genetic models for vitiligo[J].J Am Acad Dermatol,2004,51(3):383-390.
[11]Prcic S,Djuran V,Mikov A,et al.Vitiligo in children[J].Pediatr Dermatol,2007,24(6):666.
[12]Nicolaidou E,Antoniou C,Miniati A,et al.Childhood and later-onset vitiligo have diverse epidemiologic and clinical characteristics[J].J Am Acad Dermatol,2012,66(6):954-958.
[13]de Barros JC,Machado Filho CD,Abreu LC,et al.A study of clinical profiles of vitiligo in different ages:an analysis of669outpatients[J].Int J Dermatol,2014,53(7):842-848.
[14]Nicolaidou E,Antoniou C,Miniati A,et al.Childhood-and later-onset vitiligo have diverse epidemiologic and clinical characteristics[J].Am Acad Dermatol,2012,66(6):954-958.
[15]Patrizi A,Bentivogli M,Raone B,et al.Association of halo nevus/i and vitiligo in childhood:a retrospective observational study[J].J Eur Acad Dermatol Venereol,2013,27(2):148-152.
[16]Brandon E,Cohen SS,Euphemia W,et al.Comparison of childhood vitiligo presenting with or without associated halo nevi[J].Pediatr Dermatol,2016,33(1):44-48.
[17]Ezzedine K,Diallo A,Léauté-Labrèze C,et al.Halo naevi and leukotrichia are strong predictors of the passage to mixed vitiligo in a subgroup of segmental vitiligo[J].Br J Dermatol,2012,166(3):539-544.
[2]葛宏松,曹婷婷,张成,等.儿童白癜风371例临床特点分析[J].安徽医学,2013,34(9):1306-1308.
[3]Agarwal S,Gupta S,Ojha A,et al.Childhood vitiligo:Clinicoepidemiologic profile of 268children from the Kumaun region of uttarakhand,India[J].Pediatr Dermatol,2013,30(3):348-353.
[4]Silverberg JI,Silverberg B.Quality of life impairment in children and adolescents with vitiligo[J].Pediatr Dermatol,2014,31(3):309-318.
[5]Krüger C,Panske A,Schallreuter KU,et al.Disease-related behavioral patterns and experiences affect quality of life in children and adolescents with vitiligo[J].Int J Dermatol,2014,53(1):43-50.
[6]中国中西医结合学会皮肤性病专业委员会色素病学组.白癜风临床分型及疗效标准(2003修订稿)[J].中华皮肤科杂志,2004,37(7):440.
[7]黄博,许爱娥,卢良君,等.儿童白癜风396例临床分析[J].中华皮肤科杂志,2008,41(4):234-236.
[8]康元,张峻岭,史先花,等.儿童白癜风和成人白癜风分析比较[J].临床皮肤科杂志,2013,42(8):454-457.
[9]Lin X,Tang LY,Fu WW,et al.Childhood vitiligo in China:clinical profiles and immunological findings in 620cases[J].Am J Clin Dermatol,2011,12(4):277-281.
[10]Zhang XJ,Liu JB,Gui JP,et al.Characteristics of genetic epidemiology and genetic models for vitiligo[J].J Am Acad Dermatol,2004,51(3):383-390.
[11]Prcic S,Djuran V,Mikov A,et al.Vitiligo in children[J].Pediatr Dermatol,2007,24(6):666.
[12]Nicolaidou E,Antoniou C,Miniati A,et al.Childhood and later-onset vitiligo have diverse epidemiologic and clinical characteristics[J].J Am Acad Dermatol,2012,66(6):954-958.
[13]de Barros JC,Machado Filho CD,Abreu LC,et al.A study of clinical profiles of vitiligo in different ages:an analysis of669outpatients[J].Int J Dermatol,2014,53(7):842-848.
[14]Nicolaidou E,Antoniou C,Miniati A,et al.Childhood-and later-onset vitiligo have diverse epidemiologic and clinical characteristics[J].Am Acad Dermatol,2012,66(6):954-958.
[15]Patrizi A,Bentivogli M,Raone B,et al.Association of halo nevus/i and vitiligo in childhood:a retrospective observational study[J].J Eur Acad Dermatol Venereol,2013,27(2):148-152.
[16]Brandon E,Cohen SS,Euphemia W,et al.Comparison of childhood vitiligo presenting with or without associated halo nevi[J].Pediatr Dermatol,2016,33(1):44-48.
[17]Ezzedine K,Diallo A,Léauté-Labrèze C,et al.Halo naevi and leukotrichia are strong predictors of the passage to mixed vitiligo in a subgroup of segmental vitiligo[J].Br J Dermatol,2012,166(3):539-544.