| Background:Vitiligo is one of the most common depigmentary disorders of the skin and hair that results from selective destruction of melanocytes.The prevalence of vitiligo in China is approximately 0.19%.Most cases occur sporadically,about 10%～38%patients have family history and its inheritance pattern is consistent.with a polygenic trait.In recent,years,increasing attention has been paid to examine the genetic factors of vitiligo,and more than 4 loci have been found to be susceptible to vitiligo.It is also believed that vitiligo has an autoimmune basis.And vitiligo itself is a component of the APECED(APS1) and Schmidt(APS2) multiple autoimmunity syndromes.A number of studies have suggested the association of vitiligo with other autoimmune diseases,including thyroid disease,pernicious anemia,diabetes mellitus, alopecia areata,and Addison's disease.Objectives To investigate the association between vitiligo and some other autoimmune diseases,and identify some predisposing factors of this association.Methods Information was collected from 6,516 vitiligo patients.Clinical data were compiled from questionnaires.All the patients were diagnosed as vitiligo by two independe.nt dermatologists.Family structure and self-reported autoimmune disorders were collected in both the proband and theirs relatives.Results 1 Among 6,199 patients,52.8%of the patients were males and 47.2%were females. There were no significant differences between agenda distribution.2 There were 1,027 multiple familial vitiligo probands and 5,172 sporadic ones.The mean age onset of familial vitiligo probands was earlier than sporadic ones(18.7±12.5 years vs.20.4±13.9 years,p＜0.01).3 The median disease duration of familial vitiligo probands was.longer than sporadic probands(24 months vs.16 months p＜0.01).4 Among the 6,199 vitiligo probands,one of the most common immune-mediated disease was rheumatoid arthritis which affected 2.0%of patients(124),6.4 times increased(p＜0.01) from the reported 0.32%in general population.Among the 20,703 first degree relatives of vitiligo probands,0.54%(112) of them were reported as having clinical rheumatoid arthritis,more than twice high as that in general population prevalence(p＜0.01).of 1,032 familial vitiligo probands,Rheumatoid arthritis was reported in 2.0%(21) of the familial vitiligo probands,similar to that among total vitiligo probands.We also observed elevated prevalence of other autoimmune diseases in vitiligo patients.Tie prevalence of alopecia areata was also significantly elevated in vitiligo probands and their relatives.Among 6,199 vitiligo probands,0.81%(50) had alopecia areata,a 9-fold increase(P＜0.01) compared with the population prevalence of 0.085%.Similarly,0.12%(25 )ofvitiligo probands first-degree relvatives were reported to have had alopecia areata(p＜0.01).Alopecia areata was more prevalent in males (1.10%) than in females(0.44%).The prevalence of psoriasis was 0.31%(19) among vitiligo probands,notably higher than that in both general population(0.12%p＜0.01), and vitiligo probands first degree relatives(0.22%p＜0.01).The prevalence of psoriasis in familial vitiligo probands was 0.8%(8),also more-than its 0.3%prevalence among total vitiligo probands.The prevalence of chronic urticaria was 0.77%(48) among vitiligo probands,elevated for about 8 times compared with the population prevalence of 0.1%(p＜0.01),among probands first degree relatives.The prevalence of chronic urticaria was 1.5%(15 ) in the familial vitiligo probands,significantly more than 0.8%prevalence among total vitiligo probands.No significant increases in the prevalence of hypothyroidism,hyperthyroidism, diabetes mellitus,systemic lupus erythematosus,asthma,and dermatomyositis was observed.As of several other autoimmune diseases,we did not found increased prevalence among total vitiligo probands occurred at elevated prevalence among the familial vitiligo probands.Diabetes mellitus occurred in 3.1%(32) of the familial vitiligo probands,significantly more than its population prevalence 0.674%(P＜0.01).Asthma also occurred in 0.8%(8) of the familial vitiligo probands,more than its.prevalence of 0.41%in general population.Conclusions These findings indicate that vitiligo may share common genetic aetiologic links with other autoimmune diseases,and the genetic component of familial vitiligo is stronger.
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