儿童节段型白癜风的临床特点分析

Clinical analysis of segmental vitiligo in children

目的了解儿童节段型白癜风的临床特点及其病情变化。方法采用问卷调查方法收集2011年10月至2012年7月于我科门诊就诊的170例儿童节段型白癜风患者的临床流行病学资料，对照组为发病年龄在18岁以上的174例成人节段型白癜风患者。用SPSS16．0软件包对资料进行分析。结果儿童节段型白癜风患者170例，其中男108例占63．5％，女62例占36．5％，男女性别比例与成年患者组相比，差异有统计学意义（r=14．44，P〈0．05）。82．9％的儿童患者以局限型起病，成人患者为76．4％。儿童患者中76．5％半年内由局限型发展成节段型，成人为63．9％。在以局限型起病的患者中，进展半年后稳定的儿童患者占71．6％，成人患者为67．3％；以节段型起病的患者中，进展1个月后稳定的儿童患者占62．1％，成人患者为41．5％，两组比较，r=8．39，P〈0．01。44．1％的儿童患者初发于头面部，成人患者为56．9％。以单一神经节段起病的儿童患者占94．7％，成人患者为86．8％，两组比较，r=0．04，P〉0．05。儿童患者伴白发（r=15．88，P〈0．01）、自身免疫性疾病（#=5．62，P〈0．05）、有白癜风家族史的比例（r=6．66，P=0．01）均低于成年患者组。结论儿童节段型白癜风以男性多见，主要以局限型起病，70％以上的患者进展半年后病情稳定。

Objective To analyze the clinical features and evolution of segmental vitiligo in children. Methods A standardized questionnaire was used to clinically investigate segmental vitiligo in 170 children aged 〈 or = 12 years and 174 adults with an age of onset 〉 18 years. Data analysis was done by the software SPSS16.0. Results The female to male ratio was 108 ： 62 in the 170 child patients, significantly different from that in the adult patients （X^2 = 14.44, P 〈 0.05 ）. Localized vitiligo occurred as the initial presentation in 82.9% （141/170） of the children and 76.4% （133/174） of the adults, and progressed into segmental vitiligo in half a year in 76.5% of the 141 children and 63.9% of the 133 adults. Vitiligo entered the quiescent stage after half-a-year progression in 71.6% of the children and 67.3% of the aduhs with localized vitiligo as the initial presentation, and after one-month progression in 62.1% of the children and 41.5% of the adults with segmental vitiligo as the first presentation （X2 = 8.39, P 〈 0.01 ）. Head and face were affected at the onset of segmental vitiligo in 44.1% of the childhood cases and 56.9% of the adult cases. Single nerve segments were involved at the onset in 94.7% of the child patients and 86.8% of the adult patients （X^2 = 0.04, P 〉 0.05）. The proportions of patients with white hairs, autoimmune diseases, and family history were significantly lower in the child patients than in the adult patients （X^2 = 15.88, 5.62, 6.66 respectively, all P 〈 0.05）. Conclusions Childhood-onset segmental vitiligo shows a predilection for males, usually presents as localized vitiligo at the onset, and becomes quiescent after half-a-year progression in more than 70% of patients.