Autoimmune vitiligo in rheumatic disease in the mestizo Mexican population

Abstract

Vitiligo is a chronic disease characterized by the dysfunction or destruction of melanocytes with secondary depigmentation. The aim of the present study was to determine the prevalence of vitiligo associated with autoimmune rheumatic diseases. The clinical records from a 10-year database of patients with rheumatic diseases and associated vitiligo was analysed, with one group of patients having autoimmune rheumatic disease and another non-autoimmune rheumatic disease. Available serum samples were used to assess the anti-melanocyte antibodies. A total of 5,251 individual clinical files were archived in the last 10 years, and these patients underwent multiple rheumatology consultations, with 0.3% of the group presenting with vitiligo. The prevalence of vitiligo in the autoimmune rheumatic disease group was 0.672%, which was mainly associated with lupus and arthritis. However, patients with more than one autoimmune disease had an increased relative risk to develop vitiligo, and anti-melanocyte antibodies were positive in 92% of these patients. By contrast, the prevalence was 0.082% in the group that lacked autoimmune rheumatic disease and had negative autoantibodies. In conclusion, the association between vitiligo and autoimmune rheumatic diseases was relatively low. However, the relative risk increased when there were other autoimmune comorbidities, such as thyroiditis or celiac disease. Therefore, the presence of multiple autoimmune syndromes should be suspected.

Association of human beta-defensin 1 gene polymorphisms with nonsegmental vitiligo

“…It is a relatively common disorder, with a prevalence rate of 0.2–1% . Although the exact aetiology of vitiligo remains elusive, autoimmunity is believed to play an important role in disease pathogenesis, as vitiligo is often associated with autoimmune diseases . There is also evidence for a direct role for interferon‐γ‐producing CD8+ cytotoxic T lymphocytes (CTLs) in the progression of vitiligo, corresponding to a T helper (Th)1 response .…”

Melan-A expression related to apoptosis of melanocytes in segmental and non-segmental vitiligo

“…In the end, the cells become fragmented and release apoptotic bodies. [31][32][33] However, in addition to apoptosis, several authors have recently suggested that neoantigens can also be caused by another form of melanocyte cell death such as necroptosis, pyroptosis, ferroptosis, oxeiptosis, and parthanatos, which are characterized by an inflammatory process. Apoptosis that is too long can also cause necrosis and vice versa.…”

Vitiligo and systemic sclerosis: Are they associated?– Lessons from a population‐based study

“…One putative mechanism relates to the epitope spreading phenomenon, which occurs when the primary autoimmune process against SSc‐related epitopes leads to exposure of nearby epitopes, resulting in an autoimmune response against melanocytes and vice versa 28 . This mechanism is substantiated by the fact that anti‐melanocyte autoantibodies were found in 92% of individuals with multiple autoimmune rheumatic diseases 29 . Moreover, there is growing evidence that dermal fibroblasts, the effector cells of fibrosis in SSc, exert an important role in physiological pigmentation and pigmentary abnormalities 30,31 .…”