There is a potential risk of the development of vitiligo in pediatric atopic dermatitis patients owing to the Koebner phenomenon.
Vitiligo is a skin disorder associated with the loss of melanin from normal skin regions. An abnormal inflammatory response in this disorder indicates a potential association between vitiligo and atopic dermatitis (AD). Pediatric AD may potentially precede the development of vitiligo in susceptible children owing to the phenomenon of Koebner (PK). These findings are published in the journal Anais Brasileiros de Dermatologia.
Established Association Between Vitiligo and Atopic Dermatitis
There is a well-known association between vitiligo and AD, with early-onset vitiligo being a greater risk factor for AD development compared to late-onset vitiligo. The first case presented in this study discussed the presence of vitiligo in typical AD regions. The second case involved easy recognition of AD and vitiligo in different body regions. The odds ratio of vitiligo risk in patients with AD is reported to be 1.52–1.71 in adolescents and young adults, 2.83 in children, and 4.46 in adults.
Koebner Phenomenon in Vitiligo and Atopic Dermatitis
Approximately 20–60% of patients with vitiligo have reported isomorphic PK, before the age of 12 years. The first case included in this study discussed PK as resulting from the synergistic association between scratching and the pro-inflammatory effects of AD.
Genetic and Immunological Basis of Vitiligo and Atopic Dermatitis
The relationship between AD and autoimmune diseases has been attributed to genes that influence the function of T cells and the innate immune response in susceptible individuals. Shared interleukins between vitiligo and AD underlie the therapeutic response of these conditions to JAK-STAT pathway inhibitors.
This study discussed the association between AD and vitiligo in genetically susceptible individuals. The study also highlighted the positive role of PK in the development of vitiligo in pediatric AD patients.
Ravaioli, G. M., Patrizi, A., & Neri, I. (2023). Vitiligo and atopic dermatitis in young girls: may Koebner phenomenon play a role? Anais Brasileiros de Dermatologia, 98(1), 125-127. https://doi.org/10.1016/j.abd.2021.02.014