Gopal K V T, Rama Rao G Raghu, Kumar Y Hari Kishan, Appa Rao M V, Vasudev P
Department of Dermatology, Andhra Medical College, Visakhapatnam, India.
Indian J Dermatol Venereol Leprol. 2007 May-Jun;73(3):162-5. doi: 10.4103/0378-6323.32710.
Recent clinical and animal experimental studies postulate that the pathogenetic mechanisms of vitiligo could be of systemic origin as vitiligo is associated with ocular and auditory abnormalities as well as other autoimmune disorders.Hence, we studied genetic factors, systemic associations, ocular and auditory abnormalities of vitiligo.
The study group included 150 new cases of various types of vitiligo. One hundred age- and sex-matched nonvitiligo cases were included as controls in the study. A complete family history was taken for all patients. Examination was carried out taking note of the type of vitiligo and approximate percentage of body surface involved. All relevant laboratory investigations, a thorough audiological examination including pure tone audiometry and a complete ophthalmologic examination were carried out in all patients and controls. Statistical analysis was done using the Chi square test.
Fifty-four vitiligo patients (36%) had a family history of vitiligo. Anemia was present in 30 (20%) vitiligo patients but only in five (5%) controls, a difference that was statistically significant (c2 = 15.8, P < 0.001). Diabetes mellitus was present in 24 (16%) vitiligo patients and only 2 (2%) of controls (Chi square, c2 = 12.4, P < 0.001). Hypothyroidism and alopecia areata were present in 18 (12%) and 11 (7.4%) vitiligo patients respectively and none of the controls. Hypoacusis was seen in 30 (20%) vitiligo patients and two (2%) controls (c2 = 8.19, P < 0.005). Twenty-four vitiligo patients (16%) and five controls (5%) had specific ocular abnormalities like uveitis, iris and retinal pigmentary abnormalities (c2 = 7.39, P < 0.001).
This study demonstrates statistically significant clinical evidence confirming that vitiligo is a part of systemic autoimmune process.
近期临床及动物实验研究推测，白癜风的发病机制可能源于全身，因为白癜风与眼部和听觉异常以及其他自身免疫性疾病相关。因此，我们研究了白癜风的遗传因素、全身关联、眼部和听觉异常。
研究组包括150例各种类型的新发白癜风病例。100例年龄和性别匹配的非白癜风病例作为对照纳入研究。记录所有患者的完整家族史。检查时记录白癜风类型及累及体表的大致百分比。对所有患者和对照进行所有相关实验室检查、包括纯音听力测定的全面听力学检查以及完整的眼科检查。采用卡方检验进行统计分析。
54例白癜风患者（36%）有白癜风家族史。30例（20%）白癜风患者存在贫血，而对照组仅5例（5%），差异有统计学意义（χ² = 15.8，P < 0.001）。24例（16%）白癜风患者患有糖尿病，对照组仅2例（2%）（卡方检验，χ² = 12.4，P < 0.001）。白癜风患者中分别有18例（12%）和11例（7.4%）患有甲状腺功能减退症和斑秃，对照组均无。30例（20%）白癜风患者存在听力减退，对照组2例（2%）（χ² = 8.19，P < 0.005）。24例（16%）白癜风患者和5例对照组（5%）有葡萄膜炎、虹膜和视网膜色素异常等特定眼部异常（χ² = 7.39，P < 0.001）。
本研究提供了具有统计学意义的临床证据，证实白癜风是全身自身免疫过程的一部分。
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