Is vitiligo a potential condition in infants?

Vitiligo is a relatively common autoimmune disease affecting approximately 1% of the global population. It results in depigmentation of certain areas of the body. Indeed, the malfunction of the immune system leads to the loss of melanocytes , mediated by CD8+ cytotoxic T lymphocytes. Vitiligo is partially influenced by genetic factors and can appear at any age, regardless of skin type. However, it is less common in infants and babies. According to studies, the average age of onset in children is between 4 and 8 years. The exact prevalence of vitiligo in infants is unknown, but it begins before the age of 10 years in 25% of cases.

Studies on vitiligo in infants remain limited, as this condition is infrequent in this age group.

However, in rare instances, vitiligo can manifest from early childhood. Several studies have documented cases of vitiligo in newborns, including four between 1978 and 2009. For instance, a 4-month-old infant had depigmented patches on the right hand since birth, which were gradually increasing. A Wood's lamp test was conducted to distinguish vitiligo from other pigmentation disorders and the diagnosis confirmed the disease. This test is a clinical examination used in dermatology to analyse certain skin conditions, including vitiligo. It relies on the use of ultraviolet (UV) light at a wavelength of 365 nm which highlights differences in pigmentation.

Other instances have been documented, such as a 22-year-old woman and a 71-year-old man, who had vitiligo lesions on their hands and feet since birth, as well as a 2-month-old baby with lesions on the knees. Another study, published in The Journal of Clinical and Aesthetic Dermatology, reported a case of congenital vitiligo in a 27-day-old child. Since birth, depigmented spots appeared and progressed rapidly, starting in the pubic region before spreading to other areas of the body. However, these cases remain relatively rare.

Several hypotheses can be put forward to explain the onset of vitiligo in infants. The main cause of vitiligo appears to be genetic predisposition. Approximately 20% of individuals with vitiligo have a first-degree relative also affected by the condition, and the risk of developing vitiligo is 7 to 10 times higher when one of the parents is affected. In rare cases, a developmental defect in melanocytes before birth could be responsible for the early onset of vitiligo. Even though genetics is the main cause, environmental factors can also trigger or exacerbate the onset of vitiligo. Indeed, although less documented and less frequent in infants, certain triggering factors, such as viral infections or physical stress (skin traumas), could promote its development.

Although these hypotheses are being studied, the exact causes of vitiligo in infants remain poorly understood.