Association between vitiligo and smoking: A nationwide population-based study in Korea

Abstract

no study has examined the associations between vitiligo and smoking. the purpose of this study was to investigate the incidence of vitiligo according to smoking status. We used clinical data from individuals aged over 20 years who received a health examination in the National Insurance Program between 2009 and 2012 (n = 23,503,807). We excluded individuals with pre-existing vitiligo who had ever been diagnosed with vitiligo before the index year (n = 35,710) or who were diagnosed with vitiligo within a year of the index year (n = 46,476). Newly diagnosed vitiligo was identified using claims data from baseline to date of diagnosis or December 31, 2016 (n = 22,811). The development of vitiligo was compared according to self-reported smoking status by a health examination survey. the hazard ratio of vitiligo in current smokers was 0.69 (95% confidence interval; 0.65-0.72) with a reference of neversmokers after adjustment for age, sex, regular exercise, drinking status, body mass index, diabetes mellitus, hypertension, dyslipidemia, history of stroke, and history of ischemic heart diseases. the decreased risk of vitiligo in current smokers persisted after subgroup analysis of sex and age groups. The results suggested there are suppressive effects of smoking on the development of vitiligo. Further studies are needed to evaluate the mechanism of smoking on the development of vitiligo.Vitiligo is a common depigmentation skin disease with an estimated prevalence of 0.5-1% in the worldwide population 1 . Vitiligo affects all skin types and ethnic groups. The highest incidence is recorded in India (up to 8.8%) 2 , followed by Mexico (4%) 3 , Japan (1.68%) 4 , and Denmark (0.38%) 5 . The annual incidence of vitiligo in South Korea was estimated at 0.12-0.13% 6 .Vitiligo is a multifactorial disease. It is hypothesized to be mainly caused by autoimmune factors, although genetic susceptibility, oxidative stress, and cell detachment abnormalities are also suggested etiologies 7 . The autoimmune diseases vitiligo is associated with include autoimmune thyroid disorders, rheumatoid arthritis, adult-onset diabetes mellitus, pernicious anemia, and systemic lupus erythematosus 8,9 . Once vitiligo develops, it is difficult to treat and affects quality of life. Vitiligo can negatively affect social relations 10-13 . One study showed that vitiligo has an adverse effect on patient sexuality 14 , and it has been associated with pessimistic emotions such as shame, insecurity, and sadness 15 . Therefore, evaluating the preventive and risk factors for vitiligo is important.Smoking is one of the most prevalent addictive habits that affects multi-organ systems and results in several diseases. The well-known risks of smoking habits include respiratory and cardiovascular diseases. Smoking also affects the immune system and results in inflammatory reactions. Tobacco contains as many as 6,000 different components including nicotine, polycyclic aromatic hydrocarbons, tobacco glycoprotein, and some metals, many of which are considered antigenic, c...

Influences of vitiligo‐associated characteristics on the occurrence of diabetes mellitus: Interactive analysis of a cross‐sectional study

“…33 However, when it refers to the association between smoking and vitiligo, a retrospective study showed that smoking could decrease the risk of vitiligo concerning smoking dose. 34 Nevertheless, the authors of this study emphasised that smoking does not have a distinct benefit for vitiligo development. 34 It is worth mentioning that extensive clinical studies have established a strong association between smoking and the incidence and severity of vitiligo.…”

“…34 Nevertheless, the authors of this study emphasised that smoking does not have a distinct benefit for vitiligo development. 34 It is worth mentioning that extensive clinical studies have established a strong association between smoking and the incidence and severity of vitiligo. [35][36][37] The exposure to smoke has been discovered…”

“…A large cross‐sectional study from Korea showed that all types of smoking, either self‐reported former and current smoking or cotinine‐verified current smoking, were all associated with increased DM prevalence 33 . However, when it refers to the association between smoking and vitiligo, a retrospective study showed that smoking could decrease the risk of vitiligo concerning smoking dose 34 . Nevertheless, the authors of this study emphasised that smoking does not have a distinct benefit for vitiligo development 34 .…”

Cigarette smoking is an independent risk factor for developing vitiligo on the hands

“…18 A Korean study on systemic vitiligo found that smoking can decrease the risk of the condition. 19 The study analyzed a national cohort database and compared the incidence of vitiligo in nonsmokers and smokers. The results revealed that current smokers had a significantly lower risk of vitiligo than nonsmokers, with a hazard ratio of 0.51 and a 95% CI of 0.50, 0.53.…”

Nanomicelles-in-coaxial nanofibers with exit channels as a transdermal delivery platform for smoking cessation

“…7 Interestingly, smokers were proven to have a higher ability to resist vitiligo development than their non-smoking counterparts according to a nationwide population-based study performed by Lee et al on Korean people. 8…”