Nevus de Sutton y Vitiligo, Simbióticos y Dermatitis Atópico.

Does Childhood Vitiligo Differ When Halo Nevi Are Present?

Vitiligo, characterized by depigmented patches due to loss of melanocytes, affects up to 4% of individuals worldwide. Childhood vitiligo differs from adult vitiligo regarding higher prevalence of segmental disease, history of atopy, and family history of autoimmune disease. Halo nevi (HN) — nevi with an acquired depigmented peripheral zone (see NEJM JW Dermatol Nov 2012 and Am Acad Dermatol 2012; 67:582) that occur in 1% of the general population, usually on the trunk — are more common in vitiligo patients than in the general population and are considerably more common in children with vitiligo than in adults.

These authors retrospectively reviewed charts at an academic pediatric dermatology unit to characterize childhood vitiligo with and without associated HN. Over a 24-year period, 208 children presented with vitiligo, 55 (26%) of whom had HN. Children with vitiligo-associated HN were more likely to be male (62%; P= 0.03) and older at presentation than those with vitiligo alone (5.8 vs. 7.3 years; P= 0.01).

Children with vitiligo-associated HN were more likely to have the generalized vitiligo subtype. No between-group differences were observed in body surface area affected or family history of vitiligo or autoimmune diseases. Patients with HN were no more likely to develop new vitiligo over a mean of 1.9 years, and there were no significant differences in repigmentation.

Editor Disclosures at Time of Publication

• Disclosures for Mary Wu Chang, MD at time of publication Consultant / Advisory board Pierre Fabre; Valeant Speaker's bureau Pierre Fabre

The Value of Synbiotics in Atopic Dermatitis  : Dermatology News

February 24, 2016

Synbiotics can be used to treat atopic dermatitis, particularly those with mixed strains of bacteria, according to a meta-analysis of 8 studies involving nearly 1,700 children. 

Investigators analyzed the SCORAD index in 6 treatment studies involving 369 children, and the relative risk of atopic dermatitis in 2 prevention trials involving 1,320 children. 

In the treatment studies:

• Change in SCORAD index in those treated with synbiotics at 8 weeks was −6.56.  

• Heterogeneity was significant.  

• Significant effect was seen only when using mixed strains of bacteria (average score difference -7.32), and when used in children aged 1 year or older (average score difference -7.37). 

In the prevention studies, those taking synbiotics were 56% less likely than those taking placebo to develop atopic dermatitis. 

Citation: Chang Y, Trivedi M, Jha A, Lin Y, Dimaano L, Garcia-Romero. Synbiotics for prevention and treatment of atopic dermatitis: A meta-analysis of randomized clinical trials. [Published online ahead of print January 25, 2016]. JAMA Pediatr. doi:10.1001/jamapediatrics.2015.3943.