The risks of psoriasiform diseases are increased by anti-TNF agents in patients with IBD. Among psoriasiform diseases, the risk of palmoplantar pustulosis shows the biggest increase particularly in male and younger patients.

Alopecia areata (AA) is a common cause of non-scarring alopecia caused by a T cell-mediated autoimmune response to hair follicles. 1,2 The worldwide point prevalence of AA is up to 1%, 3-5 and the lifetime risk is reported to be 2% in the United States. 6 Although AA is not a life-threatening condition, it has considerable impacts on the patient's quality of life. 7,8 Glucocorticoids (topical, systemic, or intralesional) have been the traditional mainstay of treatment. Other unapproved treatment modalities include topical immunotherapies with contact sensitizers; and systemic immunosuppressants such as methotrexate, azathioprine, and cyclosporine. 9 Each modality showed various therapeutic response and also has some limitations such as injection-associated pain, skin atrophy, systemic

Vitiligo is a common acquired depigmentation disorder. Previous studies have shown that vitiligo is associated with a variety of autoimmune disorders. However, a large-scale epidemiological study focused on comorbid rheumatic disorders has not been undertaken. To clarify the associations between vitiligo and various rheumatic disorders, we performed a cross-sectional study using data from the Korean National Health Insurance claims database. Between 2009 and 2013, totals of 86 210 patients with vitiligo and 172 420 age- and sex-matched controls without vitiligo were enrolled in this study. Vitiligo patients were found to be at increased risk of systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome and rheumatoid arthritis, but no significant association was found between vitiligo and dermatomyositis/polymyositis, Behçet's disease or ankylosing spondylitis. Subgroup analysis showed an increased risk of dermatomyositis/polymyositis in male and ankylosing spondylitis in female vitiligo patients. The risks of dermatomyositis/polymyositis or ankylosing spondylitis were higher in young vitiligo patients. Our study confirms a significant association between vitiligo and rheumatic disorders. Differences in comorbid rheumatic disorders by age group and sex suggest the need for patient-specific approaches. Careful consideration of rheumatic disorders is required for the proper management of comorbidities in vitiligo patients.

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