Vitiligo in an Italian outpatient center: a clinical and serologic study of 204 patients in Tuscany

Correlation of Serum Thyroid Hormones Autoantibodies with Self-Reported Exposure to Thyroid Disruptors in a Group of Nonsegmental Vitiligo Patients

Vitiligo is a pigmentary disorder strongly associated with autoimmune thyroid disorders (ATD). Thyroid hormones antibodies (THAb) directed toward thyroxine (T3) and triiodothyronine (T4) (T3- and T4-Ab) are rare in the general population but are increased in individuals wit ATD and extrathyroid autoimmune disorders. Because it is known that alcohol, smoke, iodine, and some thyroid disruptors can elicit the appearance of ATD, the aim of our study was to evaluate possible correlation between T3- and T4-Ab expression and past toxic exposures in vitiligo patients. Seventy vitiligo patients were examined and self-reported exposure to thyroid disruptors (4,4'-isopropylidenediphenol, perchlorates, polychlorinated biphenyls (PCBs), hexachlorobenzene, resorcinol, dichlorodiphenyltrichloroethane, alachlor/amitriole, nitrate, thiocyanate, soy isoflavones), iodine intake, smoke, and alcohol consumption were investigated through standardized questionnaires. Immunoglobulin (Ig)M-T3-Ab, IgG-T3-Ab, IgM-T4-Ab,and IgG-T4-Ab were dosed by a radioimmunoprecipitation technique. Seventy-seven (95.7 %) patients had at least one type of THAb. Most of them had contemporarily both T3- and T4-Ab (50/70). We found a significant association between PCBs and T4-IgG-Ab (P = 0.039) and between food intake containing nitrate, thiocyanate, and soy isoflavones with (IgM + IgG)-T3-Ab (P = 0.041). Our study underlines a possible influence of diet and environment in vitiligo patients in eliciting THAb. Therefore, in the event of a positive exposure to thyroid disruptors, an evaluation of thyroid function might be useful to early detect possible associated thyroid autoantibodies such as THAb.

Prevailing Misconceptions of Vitiligo among Saudi School Children

OBJECTIVES

To identify the prevailing myths and misconception about vitiligo among the school students in Qassim region of Saudi Arabia.

METHODS

We conducted a cross sectional study in 18 schools of Qassim Regions in Saudi Arabia, Data was collected by 486 pre-tested, self-administered questionnaires. The questionnaires included a section on social-demographic information (age, sex, education of parents) besides prevailing myths on vitiligo. Data was analyzed by using SPSS (version 17 for Windows).

RESULTS

THE RESPONSE RATE: Males 46.3%, and females 53.3%. With vitiligo disease: 24.1% and non-diseased 75.9%, with positive family history: Males 9.3%, female 13.8%. Myths among students compared with gender: Vitiligo with; Fish/milk food (P= 0.374), calcium deficiency (P= 0.001), iron deficiency (P= <0.001), Vit C deficiency (P= 0.225), infectious (P= <0.001), Chicken pox like disease (P= <0.001), precancerous (P= 0.212) and not curable (P= <0.001). Myths among students compared with diseased/not diseased, namely that relation of vitiligo with: Fish/milk food (P= 0.006), calcium deficiency (P= <0.001), iron deficiency (P= 0.022), Vit C deficiency (P= <0.001), infectious (P= 0.228), Chicken pox like disease (P= <0.001), precancerous (P= 0.051) and not curable (P= 0.231).

CONCLUSION

The prevailing myths and conceptions delay seeking medical advice and should be addressed by focused health education programs through school health services.

Vitiligo patients from India (Mumbai) show differences in clinical, demographic and autoantibody profiles compared to patients in western countries

BACKGROUND

Vitiligo is a common, idiopathic skin disorder characterized by depigmented skin due to the loss of cutaneous melanocytes. Several studies have reported the clinical and demographic characteristics of Indian vitiligo patients, however, none has characterized their antibody profiles.

OBJECTIVE

To establish the clinical, demographic and serological details of a population of vitiligo patients from Mumbai, India, and to evaluate the data for any associations between clinical presentations and the occurrence of antibody responses.

METHODS

Vitiligo patients (n = 79) were recruited to the study and their clinical and demographic details recorded. Serum antibodies, including those against melanocyte-specific antigens, thyroid antigens and keratinocytes, were evaluated.

RESULTS

The prevalence of vitiligo was independent of sex, and non-segmental vitiligo was the most common form of the disease occurring in 65% of the patients. Patients with segmental vitiligo (mean age = 14.4 ± 4.6 years) presented at a younger age than those with non-segmental disease (mean age = 32.5 ± 17.8 years). Personal and family histories of other autoimmune diseases occurred in 3% and 8% of patients, respectively. Antibodies were detected against tyrosinase, tyrosine hydroxylase, thyroid peroxidase, thyroglobulin and keratinocytes at frequencies of 11%, 22%, 18%, 24% and 27%, respectively. Overall, antibodies were more common in patients with non-segmental vitiligo (50-67%) than in those with segmental disease (0-17%), and were detected more frequently in patients with shorter disease durations (<10 years).

CONCLUSION

Our study provides novel information relative to the clinical details, demographic features and serological parameters of a population of vitiligo patients from Mumbai, India. Important distinctions from similar surveys conducted in European patients were evident such as an infrequency of family history, a low prevalence of clinical autoimmune disease, and an absence of particular antibody specificities. These differences may have a bearing on the pathogenesis and course of the disease in Indian patients.