Comorbidities Associated with Vitiligo: A Ten-Year Retrospective Study

Abstract

Background: Vitiligo is a common disorder of depigmentation that has been associated with other autoimmune diseases. No recent large-scale data exist on the rates of comorbidities associated with vitiligo from the United States population. Objectives: To identify the prevalence of comorbidities as well as associated laboratory abnormalities in vitiligo patients. Methods: All medical records dating from January 1, 2000 to June 21, 2011 within the Research Patient Data Repository were evaluated retrospectively using a novel artificial intelligence-based computer program. A total of 3,280 patients carrying the diagnosis of vitiligo were identified using ICD-9 code 709.01. We randomly selected 300 patients and validated the diagnosis by manually reviewing their medical records. These results were used to create a model that was then applied to the larger set yielding 2,441 true vitiligo patients. 1,657 (68%) were diagnosed by dermatologists and 784 (32%) by non-dermatologists. We identified the prevalence of other comorbid autoimmune conditions by searching problem lists of vitiligo patients and collected laboratory data from the first available data point in the system for each patient. Results: Women were more frequently represented (57.6%) than men (42.4%). The majority of vitiligo patients were White/Caucasian (56.9%), followed by Hispanic/Latino (19.4%). 565 (23%) had one of the following comorbidities: 287 thyroid-related, 186 psoriasis, 72 rheumatoid arthritis, 59 alopecia areata, 55 inflammatory bowel disease, 53 systemic lupus and 20 type I diabetes mellitus. 41% had elevated anti-nuclear antibody levels. Almost half of the patients tested had elevated thyroid peroxidase antibodies. Over 50% of the patients tested had low or insufficient levels of 25-OH vitamin D. Conclusion: We found a high prevalence of comorbidities among individuals with vitiligo presenting to teaching hospitals in Boston, Mass. Comorbid autoimmune conditions were seen in 23% of vitiligo patients, thyroid disorders and psoriasis being the most common. Screening for these conditions, especially thyroid disorders, should be considered in vitiligo patients.

A case control study of vitamin D levels in patients with vitiligo

“…[12][13][14][15][16][17][18][19][20] There was no significant decrease in vitamin D levels in patients with associated autoimmune comorbidity in our study. Similar results have been found by Khurrum et al, Saleh et al as well as Beheshti et al 7,18,19 All other studies had found a significant decrease in vitamin D levels in patients having comorbid autoimmune conditions.…”

“…Similar results were obtained in a study by Finamor et al as well as Takczi et al 9,11 However the majority of patients in other studies had a mean age below 35. [6][7][8][12][13][14][15][16][17][18][19][20] This may reflect certain social attitudes towards the disease i.e. hesitancy to consult local physicians regarding vitiligo, or presenting to a tertiary center only after prolonged native treatment.…”

Comorbid autoimmune pathology in patients treated with disease modifying drugs

“…Однако, если сравнивать их рас-пространенность у больных РС, то она ниже, чем у больных с другими АИЗ. Так, например, распро-страненность заболеваний щитовидной железы у пациентов с витилиго по сравнению с контрольной группой составляет 21,1 и 7% соответственно (p=0,008) [7][8][9]. По мнению S. Ramagopalan и соавт.…”

Vitiligo and autoimmune diseases

“…Wartości te korelowały z czasem trwania choroby [10]. Podobne zależności dotyczyły przeciwciał przeciwjądrowych, które były obecne u 3,5-41% chorych, i czynnika reumatoidalnego stwierdzanego u 60% badanych [9,10,12,16]. Wielu pacjentów z bielactwem ma krążące cytotoksyczne przeciwciała skierowane przeciwko melanocytom oraz ich różnym komponentom, najczęściej przeciwko tyrozynazie -kluczowemu enzymowi w biosyntezie melaniny.…”

“…Częstość występowania u osób z bielactwem jednej lub kilku chorób autoimmunologicznych szacuje się na 14,4-25%, podczas gdy dla populacji ogólnej wartość ta wynosi niespełna 6% [7,9,12,16]. Ryzyko, że u pacjenta chorującego na bielactwo wystąpi inna choroba autoimmunologiczna, jest przeszło dwukrotnie większe niż w populacji ogólnej.…”