Late-Onset Vitiligo: Epidemiology, Clinical Characteristics, and Management Strategies.

Abstract

Background: Late-onset vitiligo (LOV), generally defined as vitiligo that starts at age 30 or older, presents unique diagnostic and management challenges, reflecting an intricate interplay of genetic, environmental, and societal factors.

Objectives: This review aims to elucidate the distinct aspects of LOV such as epidemiology, clinical characteristics, and treatment outcomes thereby enhancing diagnostic precision and planning management strategies.

Materials and methods: A comprehensive literature search was conducted across multiple databases including PubMed and EMBASE, adhering to PRISMA guidelines. Studies focused on adults (age 30 or older at the time of diagnosis) with LOV were included. Data on demographics, clinical features, and comorbidities were extracted.

Results: The literature search yielded five eligible articles with a total sample size of 1099 patients. LOV prevalence ranged from 6.5% to 14.7%, with a mean age of onset in the mid to late 50s. Vitiligo vulgaris was the most common form, with increased leukotrichia and the Koebner phenomenon. Associated autoimmune/endocrine disorders, including diabetes mellitus and thyroid diseases, were prevalent, suggesting systemic links. Treatment outcomes varied, with combination therapy and phototherapy showing promise.

Conclusion: Late-onset vitiligo differs significantly from early-onset vitiligo in its clinical traits, epidemiology, and treatment response, necessitating personalized care and targeted management strategies.