Increased risk of comorbid rheumatic disorders in vitiligo patients: A nationwide population‐based study

Abstract

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.

Dipeptidyl peptidase‐4 inhibitors lower the risk of autoimmune disease in patients with type 2 diabetes mellitus: A nationwide population‐based cohort study

“…We mainly relied on diagnostic codes for outcome ascertainment; thus, misclassification is possible, but unlikely to vary with treatment choice. In addition, to minimize the potential for outcome misclassification, all the outcomes were defined as hospitalization or 3 or more outpatient visits with a primary diagnosis of each outcome . Moreover, although we adjusted for many confounders, the results were affected by unmeasured confounders, which is a universal limitation associated with all observational studies.…”

“…The outcomes assessed were incidence of RA, IBD, other autoimmune diseases including MS and SLE, and a composite outcome of RA, IBD, MS and SLE. A patient was considered to have a first event if they were hospitalized or had 3 or more outpatient visits with a primary diagnosis of each outcome (ICD‐10 codes for RA: M05–06; for IBD: K50–51; for MS: G35; for SLE: M32) . The outcome date refer to the earliest date of outcome in a patient.…”

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

“…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. 2,3 There is also evidence for a direct role for interferon-c-producing CD8+ cytotoxic T lymphocytes (CTLs) in the progression of vitiligo, corresponding to a T helper (Th)1 response. 4,5 In addition, Th17 response has already been acknowledged to play an important role in vitiligo pathogenesis.…”

Increased risk of idiopathic pulmonary fibrosis in inflammatory bowel disease: A nationwide study

“…16 Several comorbidities included asthma (ICD-10 code: J45), allergic rhinitis (ICD-10 code: J30), atopic dermatitis (ICD-10 code: L20), systemic lupus erythematosus (ICD-10 code: M32), dermatopolymyositis (ICD-10 code: M33), systemic sclerosis (ICD-10 code: M34), polyarteritis nodosa (ICD-10 code: M30), other necrotizing vasculopathies (ICD-10 code: M31), and other systemic involvement of connective tissue (ICD-10 code: M35), which are associated with the use of steroids were additionally identified using ICD-10 codes. 17,18 Low income was defined as a monthly income in the lowest 20% of the total population distribution. This study was approved by the institutional review board of the Seoul National University Hospital (1703-107-840).…”