Prevalence of Thyroid Abnormalities in Thai Patients with Vitiligo

Abstract

Background Vitiligo is an acquired hypopigmentary disorder. The prevalence of vitiligo is 0.1–2% worldwide. Numerous autoimmune diseases are associated with vitiligo, including autoimmune thyroid diseases. The prevalence of thyroid abnormalities is up to 34% in vitiligo patients depending on ethnicities. Objective This study aims to investigate thyroid abnormalities in Thai patients with vitiligo. Methods Medical records of vitiligo patients attending outpatient dermatology clinic at a university-based hospital from 2012 to 2016 were retrospectively reviewed. Data regarding vitiligo, clinical features, and autoimmune thyroid laboratory results were retrieved and analyzed. Results Among 325 vitiligo patients identified, anti-thyroid peroxidase and anti-thyroglobulin were positive in 90 (27.7%) and 63 patients (19.4%), respectively. Positive thyroid antibody was associated with female gender (p < 0.001) and vitiliginous hand lesions (p < 0.02). Out of 197 patients with complete thyroid function test, the prevalence of autoimmune thyroid diseases (AITD) is 12.7%. Female, nonsegmental type, higher affected area, and the presence of leukotrichia are significantly associated with AITD in vitiligo patients. Conclusions Prevalence of positive thyroid antibodies and AITD in Thai patients with vitiligo is compatible with previous studies around the world. Screening for AITD with thyroid antibodies and serum TSH is essential for vitiligo patients.

Zinc, vitamin D and TSH levels in vitiligo patients

“…Previous studies have reported presence of hypothyroidism in 15-40% of patients with vitiligo in different regions (1,7,10,16,17). Similar to our findings, Sedighe and Gholamhossein (16) Studies have suggested screening for thyroid abnormalities in these patients with no united guidelines; most of the guidelines have recommend screening in those with familial history of thyroid disease, female gender, longer duration and stressful events (9).…”

“…The disease etiology is complex and multifactorial, including autoimmune, neural, and self-destructive mechanisms as well as genetics, environment, inflammatory, and oxidative stress origin (6)(7)(8)(9). The disease association with other autoimmune diseases, such as systemic lupus erythematosus, scleroderma, alopecia areata, and autoimmune thyroid diseases, has been demonstrated before (1,4,(7)(8)(9)(10). Even recent studies have suggested that thyroid autoimmunity would trigger and affect the depigmentation process of vitiligo (8).…”

The necessity of antinuclear antibody investigation in pre‐phototherapy vitiligo patients: A retrospective study

“…In our study, the prevalence of ANA positivity among the vitiligo patients was 35.3%, which was relatively high, compared with other studies 9 . Furthermore, compared to the ANA‐negative group, the ANA positivity was associated with the female gender and positive anti‐thyroglobulin.…”

The convergence theory for vitiligo: A reappraisal

“…Patients will report itch and ongoing inflammation when lesions newly develop or expand, even if the severity of pruritus does not match that reported in atopic dermatitis . Interestingly, patients with vitiligo are more likely to develop vitiligo and vice versa .…”

“…[48] A critical finding may be that lower ATP production caused by mitochondrial dysfunction in vitiligo melanocytes can be compensated for by stabilizing mitochondrial cardiolipin. [49] Patients will report itch and ongoing inflammation when lesions newly develop or expand, [50,51] even if the severity of pruritus does not match that reported in atopic dermatitis. [52] Interestingly, patients with vitiligo are more likely to develop vitiligo and vice versa.…”