Adult Onset Vitiligo: Multivariate Analysis Suggests the Need for a Thyroid Screening

Abstract

Background. There are limited epidemiological studies evaluating the effect of age at onset on disease features in vitiligo. Objectives. To identify factors associated with adult onset vitiligo in comparison with childhood onset vitiligo. Patients and Methods. We retrospectively collected medical records of 191 patients. Such records included clinical examination, personal and familial medical history, laboratory evaluations, concomitant vitiligo treatment and drug assumption. Results. 123 patients with a disease onset after the age of 40 (adult onset vitiligo) were compared with 68 patients who developed vitiligo before the age of 12 (childhood onset vitiligo). Multivariate analysis revealed that personal history of thyroid diseases (P = 0.04; OR 0.4), stress at onset (P = 0.002; OR = 0.34), personal history of autoimmune thyroid disease (ATD) (P = 0.003; OR = 0.23), and thyroid nodules (P = 0.001; OR 0.90) were independently associated with adult onset vitiligo, whereas family history of dermatological diseases (P = 0.003; OR = 2.87) and Koebner phenomenon (P < 0.001; OR = 4.73) with childhood onset vitiligo. Moreover, in the adult onset group, concomitant thyroid disease preceded vitiligo in a statistically significant number of patients (P = 0.014). Conclusions. Childhood onset and adult onset vitiligo have different clinical features. In particular, ATD and thyroid nodules were significantly associated with adult onset vitiligo, suggesting that a thyroid screening should be recommended in this group of patients.

The positive correlation between serum malondialdehyde levels with vitiligo severity and activity

“…Lazzeri et al (2016) shared similar results in which out of 188 patients with vitiligo, the non-segmental type was more commonly found (94.68%), followed by segmental type (4.26%) and unclassifiable vitiligo (1.06%). 13 Wang et al (2013) conducted a similar study in China with the results which showed that nonsegmental vitiligo is the most common vitiligo found in the community. 14 Another study by Sun et al (2006) and Mchepange et al (2010) also showed similar results.…”

“…A study by Lazzeri et al (2016) had the similar results in which out of 191 patients with vitiligo, late-onset vitiligo was more commonly found (64.40%) compared to early-onset vitiligo (35.60%). 13 Segmental vitiligo is the most common type found in this study (73.44 %). Lazzeri et al (2016) shared similar results in which out of 188 patients with vitiligo, the non-segmental type was more commonly found (94.68%), followed by segmental type (4.26%) and unclassifiable vitiligo (1.06%).…”

Comorbidities in vitiligo: comprehensive review

“…Vitiligo usually precedes thyroid disorders by many years, even decades . The opposite is also reported by some studies . Among the autoimmune thyroid diseases present in vitiligo patients, many studies find hypothyroidism to be the most common .…”

“…14,32 The opposite is also reported by some studies. 25,41 Among the autoimmune thyroid diseases present in vitiligo patients, many studies find hypothyroidism to be the most common. 5,22,25 Another study found Grave's disease to be the most frequent in vitiligo patients.…”

The effect of topical piperine combined with narrowband UVB on vitiligo treatment: A clinical trial study

“…Immunological interventions using levamisole, isoprinosine, and topical tacrolimus (Nordal, Guleng, & Rönnevig, ) are also another options. Moreover, surgical methods including full‐thickness punch and split‐thickness grafts, transplant of melanocyte–keratinocyte cultured suspension, and transplantation of pure melanocyte cultured suspension have been performed as well (Hossani‐Madani & Halder, ; Lazzeri, Colucci, Cammi, Dragoni, & Moretti, ; Pasricha & Khera, ; Toossi et al, ).…”