Melathil Sadanandan Sadeep1, Kunjumani Sobhanakumari2, Balan K. Anju3
BACKGROUND
Vitiligo is an acquired pigmentary disorder characterised by the development of white macules related to the selective loss of melanocytes residing in the interfollicular epidermis and occasionally in the hair follicles as well. Exact aetiology of vitiligo is not known. A convergence theory, which states that stress, infection, mutations, autoimmunity, accumulation of toxic compounds, altered cellular environment and impaired melanocyte migration or proliferation- all can contribute to development of vitiligo. However, most favoured hypothesis is autoimmune because vitiligo is frequently associated with other disorders, which have an autoimmune origin such as Autoimmune Thyroid Disease (AITD) and Diabetes Mellitus (DM). Recent studies suggest that vitiligo is not just a cutaneous disorder, but a systemic disorder of the pigmentary system.
MATERIALS AND METHODS
This is a hospital-based one year cross-sectional study of all vitiligo patients attending the outpatient wing of a tertiary care centre in Kerala. Patients were included after getting the written consent and those patients who had under gone thyroid surgery and on drugs that can interfere with thyroid function were excluded.
RESULTS
After meeting the criteria, only 122 patients out of 61,750 outpatients (0.19%) were included in this study. The youngest participant was 4 years, while the eldest was 69 years old. Most common age group- 10-19 years. 56.6% were females. Duration of disease was less than 2 years in 61.8%. Majority (36.9%) patients were students. A personal history of thyroid disease was obtained in 12.29%. 55.7% had positive family history of diseases like diabetes, thyroid disease, vitiligo and rheumatoid arthritis. Among the diseases noted in family members, diabetes was the commonest accounting for 32%. Though vitiligo vulgaris was common, percentage of focal and acrofacial vitiligo was higher than other studies. Vitiligo vulgaris was more commonly seen among females with a significant p value of 0.007. Infertility was observed in a significant proportion of vitiligo vulgaris patients (p=0.021). 58.9% had generalised vitiligo was more common among those who had an earlier onset of disease (p=0.013). Statistically significant correlation was obtained between generalised vitiligo and other concurrent diseases- Diabetes mellitus (p=0.010), AITD (p=0.003) and thyroid diseases taken together (hyper/hypothyroidism + AITD) (p=0.016).
CONCLUSION
The observed associations of vitiligo in our study indicate the need for screening vitiligo patients for diabetes and thyroid disease, at least in those with a generalised disease.
