Clinical Research Program, Department of Dermatology, Brigham and Women's Hospital, Boston, Mass., USA.
Dermatology. 2013;227(4):311-5. doi: 10.1159/000354607. Epub 2013 Oct 4.
Vitiligo is a common disorder of depigmentation that has been associated with other autoimmune diseases. No recent large-scale data exist on the rates of comorbidities associated with vitiligo from the United States population.
To identify the prevalence of comorbidities as well as associated laboratory abnormalities in vitiligo patients.
All medical records dating from January 1, 2000 to June 21, 2011 within the Research Patient Data Repository were evaluated retrospectively using a novel artificial intelligence-based computer program. A total of 3,280 patients carrying the diagnosis of vitiligo were identified using ICD-9 code 709.01. We randomly selected 300 patients and validated the diagnosis by manually reviewing their medical records. These results were used to create a model that was then applied to the larger set yielding 2,441 true vitiligo patients. 1,657 (68%) were diagnosed by dermatologists and 784 (32%) by non-dermatologists. We identified the prevalence of other comorbid autoimmune conditions by searching problem lists of vitiligo patients and collected laboratory data from the first available data point in the system for each patient.
Women were more frequently represented (57.6%) than men (42.4%). The majority of vitiligo patients were White/Caucasian (56.9%), followed by Hispanic/Latino (19.4%). 565 (23%) had one of the following comorbidities: 287 thyroid-related, 186 psoriasis, 72 rheumatoid arthritis, 59 alopecia areata, 55 inflammatory bowel disease, 53 systemic lupus and 20 type I diabetes mellitus. 41% had elevated anti-nuclear antibody levels. Almost half of the patients tested had elevated thyroid peroxidase antibodies. Over 50% of the patients tested had low or insufficient levels of 25-OH vitamin D.
We found a high prevalence of comorbidities among individuals with vitiligo presenting to teaching hospitals in Boston, Mass. Comorbid autoimmune conditions were seen in 23% of vitiligo patients, thyroid disorders and psoriasis being the most common. Screening for these conditions, especially thyroid disorders, should be considered in vitiligo patients.
白癜风是一种常见的色素减退疾病，与其他自身免疫性疾病有关。目前尚无美国人群中与白癜风相关的合并症发生率的最新大规模数据。
确定白癜风患者的合并症患病率以及相关的实验室异常。
使用基于新型人工智能的计算机程序，对 2000 年 1 月 1 日至 2011 年 6 月 21 日期间的 Research Patient Data Repository 中的所有病历进行回顾性评估。使用 ICD-9 代码 709.01 共识别出 3280 例患有白癜风的患者。我们随机选择了 300 例患者，并通过手动审查其病历来验证诊断。这些结果用于创建一个模型，然后将其应用于更大的数据集，得出 2441 例真正的白癜风患者。其中 1657 例（68%）由皮肤科医生诊断，784 例（32%）由非皮肤科医生诊断。我们通过搜索白癜风患者的问题清单来确定其他自身免疫性合并症的患病率，并从每位患者的系统中第一个可用数据点收集实验室数据。
女性（57.6%）比男性（42.4%）更常见。大多数白癜风患者为白人/高加索人（56.9%），其次是西班牙裔/拉丁裔（19.4%）。565 例（23%）患者存在以下一种或多种合并症：287 例甲状腺相关疾病，186 例银屑病，72 例类风湿关节炎，59 例斑秃，55 例炎症性肠病，53 例系统性红斑狼疮和 20 例 1 型糖尿病。41%的患者抗核抗体水平升高。几乎一半的患者甲状腺过氧化物酶抗体升高。超过 50%的患者测试 25-羟维生素 D 水平低或不足。
我们在马萨诸塞州波士顿的教学医院发现，白癜风患者中存在较高的合并症患病率。23%的白癜风患者存在合并自身免疫性疾病，甲状腺疾病和银屑病最为常见。应考虑在白癜风患者中筛查这些疾病，尤其是甲状腺疾病。
