Patients With Vitiligo Have a Significantly Lower Risk for All-Cause Mortality

Patients with vitiligo were found to have a lower risk of all-cause mortality, suggesting that vitiligo-associated autoimmunity may contribute to reduced morbidity and mortality, according to study results published in The Journal of Investigative Dermatology.

In a large, population-based cohort study, investigators evaluated morbidity and mortality rates among patients with vitiligo. The investigators sourced data from the National Health Insurance Service database and the National Death Registry in Korea between 2002 and 2019. They identified a total of 189,280 adult patients aged 18 years and older who had more than 3 documented visits with ICD-10 code L80. The investigators assessed the incidence risk and risk for all-cause and cause-specific mortality. Patients with preexisting vitiligo before 2003 were excluded. The study included a total of 107,424 patients with vitiligo and 537,120 sociodemographically matched controls without vitiligo. Patients’ mean age was 48.09 years, and 39.61% of participants were men.

Over a mean (SD) follow-up period of 6.5 (4.1) years, patients with vitiligo had a lower mortality rate of 34.8 per 10,000 person-years compared with a mortality rate of 45.3 per 10,000 person-years in the control group. The 5-year mortality rate for patients with vitiligo was 1.2% (95% CI, 1.1%-1.2%), compared with a rate of 1.7% (95% CI, 1.6%-1.7%) in the control group. The 10-year mortality rate for patients with vitiligo was 3.3% (95% CI, 3.1%-3.4%), vs 4.2% (95% CI, 4.2%-4.3%) for the control group. Patients with vitiligo had an overall significantly lower risk for all-cause mortality, with a fully-adjusted hazard ratio of 0.75 (95% CI, 0.72-0.78) compared with the control group.

Regarding cause-specific mortalities, patients with vitiligo experienced a significant reduction in the risk of developing life-threatening infectious, oncologic, hematologic, endocrine, neurologic, cardiovascular, respiratory, and renal/urogenital diseases.

Among several study limitations, the investigators were unable to estimate mortality risk based on severity and subtypes of vitiligo (owing to a lack of information). Furthermore, unmeasured factors (such as medication use) may have introduced bias into the findings. Selection bias may have influenced the results, given that patients with vitiligo who visit hospitals frequently may be generally healthier than those who do not, and frequent visits to doctors for management of vitiligo could provide greater opportunities for possible early detection of other diseases.

The investigators concluded, “In this population-based cohort study, patients with vitiligo were associated with substantially lower all-cause and cause-specific mortality.” They added, “The autoimmunity of vitiligo seems to have a protective effect against infections, inflammation, and cancers and further studies will be necessary to confirm this finding.”