The relationship between stress and vitiligo: Evaluating perceived stress and electronic medical record data

Abstract

Vitiligo is a T-cell mediated skin disorder characterized by progressive loss of skin color. In individuals genetically predisposed to the disease, various triggers contribute to the initiation of vitiligo. Precipitating factors can stress the skin, leading to T-cell activation and recruitment. Though hereditary factors are implicated in the pathogenesis of vitiligo, it is unknown whether precipitating, stressful events play a role in vitiligo. To understand this, we utilized a validated perceived stress scale (PSS) to measure this parameter in vitiligo patients compared to persons without vitiligo. Additionally, we probed a clinical database, using a knowledge linking software called ROCKET, to gauge stress-related conditions in the vitiligo patient population. From a pool of patients in an existing database, a hundred individuals with vitiligo and twenty-five age-and sex-matched comparison group of individuals without vitiligo completed an online survey to quantify their levels of perceived stress. In parallel, patients described specifics of their disease condition, including the affected body sites, the extent, duration and activity of their vitiligo. Perceived stress was significantly higher among vitiligo individuals compared to those without vitiligo. ROCKET analyses suggested signs of metabolic-related disease (i.e., 'stress') preceding vitiligo development. No correlation was found between perceived stress and the stage or the extent of disease, suggesting that elevated stress may not be a consequence of pigment loss alone. The data provide further support for stress as a precipitating factor in vitiligo development.

Amino acids targeted based metabolomics study in non-segmental Vitiligo: a pilot study

“…On the other hand, some studies previously reported the influence of glutamate imbalance through glutamatergic neurotransmission with anxiety and stress [41][42][43]. Our findings indicated that glutamate also engaged in this prevalent psychiatric disorder in the patients, which has been described in vitiligo frequently [5][6][7][8].…”

“…However, the main problems accompanied with vitiligo are related to its psychological aspect which is experienced by many patients around the world [4]. The levels of hopelessness, anxiety, depression, and general health of vitiligo patients was also compared to normal controls in several studies [5][6][7][8]. Hamidizadeh et al demonstrated that anxiety and hopelessness levels were significantly higher in vitiligo patients than those of healthy controls.…”

Therapeutic considerations related to stress levels associated with hand eczema: A c linico‐etiological study

“…It is known to have established and acceptable psychometric properties. 13,14,25,26 Even though PSS has been widely used in dermatology in recent years, [27][28][29][30][31] except for the study by Hafsia et al, 10 it has not been used to assess the role of stress in cases of hand eczema, and hence is underutilised. In the present study, PSS scores was calculated for all the 62 participants and it was found that 42 (67.7%) of them had increased stress scores, of which 10 (6.1%)…”

Antigen Specificity Enhances Disease Control by Tregs in Vitiligo

“…Vitiligo is an autoimmune disease wherein melanocytes are progressively destroyed, resulting in pale, white patches of skin (1,2). The prevalence of vitiligo is 0.5-1%, and this disorder is associated with low self-esteem, psychological stress, and social stigma (3)(4)(5). Therapies currently available for vitiligo have limited efficacy, and a real need for new treatment strategies exists (6).…”