Department of Dermatology and Venerology, Tartu University, and United Laboratories, Tartu University Hospital, Tartu, Estonia.
J Eur Acad Dermatol Venereol. 2012 Jul;26(7):915-8. doi: 10.1111/j.1468-3083.2011.04131.x. Epub 2011 May 31.
Most cases of vitiligo are sporadic, but about 10-36% of the patients have positive family history.
The aim of our study was to describe differences between familial and sporadic cases of vitiligo.
A total of 186 adult vitiligo patients were examined, in 173 of whom the level of thyroid peroxidase antibodies, gastric parietal cell antibodies (PCA), antinuclear antibodies (ANA), anti-adrenal cortex antibodies and rheumatoid factor in blood was measured. All patients were divided in two groups: the cases with positive family history of vitiligo (51) and the sporadic cases (135).
The risk of onset of the disease up to 20 years of age was higher in the familial group (P=0.008). Patients in familial group showed more widespread depigmentation compared with sporadic cases [body surface area (BSA) over 10%: P=0.004; BSA over 50%: P=0.001]. In familial group, patients had darker skin phototype (P=0.045) and the disease had started more often as a vulgar vitiligo (P=0.008). In sporadic vitiligo group, female gender was a risk factor for more widespread depigmentation (BSA over 10%, P=0.001). Extensive depigmentation was associated with reported triggering factors and mucosal involvement in both groups and with leukotrichia only in familial group. Widespread depigmentation related to the risk of presence of autoantibodies (P=0.03) in sporadic cases of vitiligo (especially of PCA: P=0.04 and ANA: P=0.0002).
In this study, we demonstrated first time that patients with familial vitiligo have a higher risk for vulgar type at the beginning of the disease and female gender increases the risk for more extensive depigmentation in sporadic cases.
大多数白癜风病例为散发性，但约 10-36%的患者有阳性家族史。
本研究旨在描述家族性和散发性白癜风病例之间的差异。
共检查了 186 例成年白癜风患者，其中 173 例患者检测了甲状腺过氧化物酶抗体、胃壁细胞抗体 (PCA)、抗核抗体 (ANA)、抗肾上腺皮质抗体和类风湿因子在血液中的水平。所有患者分为两组：有白癜风阳性家族史的病例（51 例）和散发性病例（135 例）。
家族组发病年龄在 20 岁以下的风险更高（P=0.008）。与散发性病例相比，家族组患者的色素脱失更广泛[体表面积 (BSA)超过 10%：P=0.004；BSA 超过 50%：P=0.001]。在家族组中，患者的皮肤肤色更深（P=0.045），疾病更常以寻常型白癜风开始（P=0.008）。在散发性白癜风组中，女性是 BSA 超过 10%的广泛色素脱失的危险因素（P=0.001）。两组均有广泛的色素脱失与报道的触发因素和黏膜受累有关，而家族组仅与白发有关。广泛的色素脱失与自身抗体的存在相关（P=0.03）在散发性白癜风病例中（尤其是 PCA：P=0.04 和 ANA：P=0.0002）。
本研究首次表明，家族性白癜风患者在疾病初期更易出现寻常型，女性性别增加了散发性病例中更广泛色素脱失的风险。
