Clinicodemographic Features and Usage of Oral Immunosuppressive Agents in Childhood and Adolescent Vitiligo: Retrospective Chart Review From a Tertiary Care Centre in Northern India

Background Vitiligo is a common acquired depigmentation disorder with significant psychosocial implications, especially in pediatric populations. Despite the availability of topical treatments, systemic immunosuppressive agents are increasingly being explored for progressive disease. However, limited data exist regarding their efficacy and safety in pediatric vitiligo. This study aims to analyze clinicodemographic features and treatment responses to systemic immunosuppressants in childhood and adolescent vitiligo. Methods A retrospective chart review was conducted at a tertiary care center in Northern India, evaluating pediatric vitiligo patients (≤ 18 years) from 2017 to 2023. Clinicodemographic data, disease subtypes, associated comorbidities, and treatment outcomes were assessed. Treatment regimens included topical corticosteroids, tacrolimus, oral mini‐pulse (OMP) corticosteroids, and systemic immunosuppressants such as azathioprine, methotrexate, and tofacitinib. Disease stabilization, repigmentation rates, and relapse frequencies were analyzed. Results A total of 304 pediatric vitiligo patients were included, with a median age of 10 years and a slight male predominance (51.3%). Non‐segmental vitiligo (NSV) was the most common subtype (93.7%), with 17.7% exhibiting Koebner's phenomenon. OMP therapy led to disease stabilization in 63.6% of cases, though 25.3% experienced relapses post‐discontinuation. Azathioprine achieved disease control in 17.7%, methotrexate in 52%, and tofacitinib in 88.9% of cases. Phototherapy showed good response rates with minimal relapses. No severe adverse effects were observed. Conclusions Systemic immunosuppressants demonstrate efficacy in stabilizing progressive pediatric vitiligo with manageable side effects. Early intervention and individualized treatment approaches are crucial in minimizing relapses and improving long‐term outcomes. Future research should focus on larger cohorts and extended follow‐up to optimize therapeutic protocols for pediatric vitiligo.