We read with great interest the article by Njoo et al,1 which gives valuable insight into the development, implementation, and evaluation of guidelines for the treatment of vitiligo by local physicians as well as experts. However, some important aspects of vitiligo in childhood should be considered. Because the course of this pigmentary disorder is variable, there is no evidence that early treatment of minimal disease alters the natural history.2 Since vitiligo is not a life-threatening cutaneous condition, many children with little skin involvement in cosmetically unimportant areas do not wish to treat their disease.2,3This should be considered when treating children and establishing guidelines.
Möhrenschlager M, Schnopp C, Abeck D. Guidelines for Treatment of Vitiligo: Is an Update Pending If Recommendations for Children Are Not Followed?. Arch Dermatol. 2000;136(9):1173. doi: