Study Finds Multiple New Disease Associations With Vitiligo

Vitiligo (Photo By BSIP/UIG Via Getty Images)
Clinicians should be aware of comorbidities that can occur with vitiligo and how these can vary by demographic group.

Cohort study data published in the Journal of the American Academy of Dermatology identified multiple new disease associations with vitiligo, including multiple sclerosis, idiopathic thrombocytopenic purpura (ITP), and lymphoma. Study results also affirmed known associations between vitiligo and certain autoimmune diseases, including hypothyroidism and rheumatoid arthritis.

Investigators conducted a retrospective cohort study of patients with vitiligo who presented to NYU Langone Medical Center for medical care. All available records from 2005 to 2015 were reviewed. Demographic and clinical data were extracted, including vitiligo type and body surface area of involvement. Medical history, including the presence of comorbid conditions, was assessed. Univariate analyses were performed to compare the prevalence rates of each comorbidity in the patient cohort.

The study cohort comprised 1487 patients with vitiligo, among whom 55.1% were women and 46.7% were white. The most common comorbidities were hypothyroidism and rheumatoid arthritis, which were present in 7.6% and 1.6% of the cohort, respectively. Compared with the general population, the vitiligo cohort had a 1.65-fold higher prevalence of hypothyroidism (P <.0001) and a 2.14-fold higher prevalence of rheumatoid arthritis (P =.001).

Patients also had a significantly higher prevalence of multiple sclerosis (4.48-fold increase; P <.0001), ITP (70-fold increase; P <.0001), seronegative arthritis (3.68-fold increase; P <.0001), pernicious anemia (2.73-fold increase; P =.012), myasthenia gravis (13.33-fold increase; P <.0001), inflammatory bowel disease (2.13-fold increase; P =.002), lymphoma (3.33-fold increase; P <.0001), and systemic lupus erythematosus (4.11-fold increase; P <.0001).

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Black patients had the highest rate of comorbid autoimmune disease (16.4%), followed by white patients (16.3%), Hispanic patients (15.7%), South Asian patients (8.4%), and East Asian patients (7.9%). Autoimmune diseases were more prevalent in women (17.7%) compared with men (6.7%).

These data found new disease associations with vitiligo, while also confirming known associated comorbidities. “Future studies examining disease associations with vitiligo across large cohorts of patients in various populations will be helpful in providing further guidance as to what diseases should be screened for amongst vitiligo patients and what differences may exist amongst varied demographic groups,” concluded the researchers.

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Hadi A, Wang JF, Uppal P, Penn LA, Elbuluk N. Comorbid diseases of vitiligo: a ten-year cross-sectional retrospective study of an urban United States population [published online July 17, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2019.07.036