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September 2000

Guidelines for Treatment of Vitiligo: Is an Update Pending If Recommendations for Children Are Not Followed?—Reply

Arch Dermatol. 2000;136(9):1173-1174. doi:

In reply

We hereby respond to the comments of our colleagues Mohrenschlager et al with regard to our article.1 Their comments are directed specifically to the treatment recommendations for children younger than 12 years.

The authors mention that "not a single physician stuck to the presented first-choice recommendation." We cannot agree with this comment. In Table 3 of our article, we indicate that the first-choice therapy for children is a class 3 corticosteroid (plus UV-A therapy). In Table 4, we indicate that in 23 (52%) of the 44 cases of vitiligo in children, the physicians indeed chose a class 3 corticosteroid (plus UV-A therapy), thus adhering to the guidelines.1 The relatively low compliance rate when compared with adults may be explained by the way the treatment scheme was formulated for children. No further distinction was made in the several clinical types or the disease activity. In a recent study, we and Dr Bos2 demonstrated that narrowband UV-B therapy is also effective and safe in children with generalized vitiligo. The data from this trial are currently being discussed within our guideline development group. These data will probably lead to an evidence-based adjustment of the current treatment scheme for children.

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