Topical calcineurin inhibitors , topical corticosteroids , and topical Janus kinase inhibitors are supported as mainstay treatments in new expert recommendations on the use of topical therapeutics in children, adolescents, and young adults withWhile half of all vitiligo cases manifest within the initial two decades of life, no guidelines specifically address the management of pediatric, adolescent, and young adult patients with vitiligo.
A protocol was established to formulate consensus recommendations addressing questions related to pediatric vitiligo. Overall, 50 articles on topical corticosteroids and/or topical calcineurin inhibitors, five on topical Janus kinase inhibitors, and two each on pseudocatalase andTCIs, TCSs, JAK inhibitors, and phototherapy, specifically narrowband ultraviolet -B light therapy, are mainstay treatments; the combination of UV-B light and topical therapy may enhance initial repigmentation.
The choice of TCS class depends on the site and planned usage duration. Short-term use or overlap with TCIs is recommended because of the risk for atrophy with long-term TCS use. Class 5-6 agents are another option.cream, are recommended for patients aged ≥ 12 years, as first- or second-line therapy. Limitation to 10% body surface area is recommended to minimize systemic absorption. Limited evidence exists for children aged < 12 years.
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