A challenge in paediatrics: concurrent atopic dermatitis and vitiligo

Abstract

Atopic dermatitis is one of the most common dermatoses globally. It has been established that it can often be associated with a variety of autoimmune diseases. Vitiligo is one of such comorbidities. This concurrent combination is most often found in paediatric practice, as an early onset is typical for both diseases. Early onset of vitiligo and involvement of a larger area of skin have been shown to be associated with higher odds of atopic dermatitis. The pathogenesis of vitiligo is characterized by altered immune responses, and genetic factors also counts. It has been shown that some of these mechanisms are shared with the pathogenesis of atopic dermatitis, but the issue warrants further study. Oxidative stress triggering melanocytes destruction is believed to be a key factor in the development of vitiligo. In this regard, patients with vitiligo are advised to use photoprotective agents. Today, the study of effects of visible light on the skin is a very topical issue, specifically, particular attention is paid to blue light (400-500 nm). Studies show that it is this wavelength that has a more pronounced negative effect on the skin. However, research findings are contradictory, as this spectrum radiation is used in the treatment of various dermatoses, including atopic dermatitis. Thus, the concurrent vitiligo and atopic dermatitis place certain restrictions on the choice of therapy, care products and photoprotective agents. A photoprotective agent for such difficult patients should protect the skin from exposure to as wide solar radiation spectrum as possible and at the same time not contain potentially allergenic components that can aggravate the course of atopic dermatitis.