Dunlap Rachel, Wu Shaowei, Wilmer Erin, Cho Eunyoung, Li Wen-Qing, Lajevardi Newsha, Qureshi Abrar
Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
J Invest Dermatol. 2017 Jun;137(6):1234-1239. doi: 10.1016/j.jid.2017.02.004. Epub 2017 Feb 14.
Vitiligo is the most common cutaneous depigmentation disorder worldwide, yet little is known about specific risk factors for disease development. Using data from the Nurses' Health Study, a prospective cohort study of 51,337 white women, we examined the associations between (i) pigmentary traits and (ii) reactions to sun exposure and risk of incident vitiligo. Nurses' Health Study participants responded to a question about clinician-diagnosed vitiligo and year of diagnosis (2001 or before, 2002-2005, 2006-2009, 2010-2011, or 2012+). We used Cox proportional hazards regression models to estimate the multivariate-adjusted hazard ratios and 95% confidence intervals of incident vitiligo associated with exposures variables, adjusting for potential confounders. We documented 271 cases of incident vitiligo over 835,594 person-years. Vitiligo risk was higher in women who had at least one mole larger than 3 mm in diameter on their left arms (hazard ratio = 1.37, 95% confidence interval = 1.02-1.83). Additionally, vitiligo risk was higher among women with better tanning ability (hazard ratio = 2.59, 95% confidence interval = 1.21-5.54) and in women who experienced at least one blistering sunburn (hazard ratio = 2.17, 95% confidence interval = 1.15-4.10). In this study, upper extremity moles, a higher ability to achieve a tan, and history of a blistering sunburn were associated with a higher risk of developing vitiligo in a population of white women.
白癜风是全球最常见的皮肤色素脱失性疾病，但对于疾病发生的具体风险因素却知之甚少。利用护士健康研究的数据，一项针对51337名白人女性的前瞻性队列研究，我们研究了（i）色素沉着特征和（ii）日晒反应与白癜风发病风险之间的关联。护士健康研究的参与者回答了关于临床医生诊断的白癜风及诊断年份（2001年或之前、2002 - 2005年、2006 - 2009年、2010 - 2011年或2012年及以后）的问题。我们使用Cox比例风险回归模型来估计与暴露变量相关的新发白癜风的多变量调整风险比和95%置信区间，并对潜在混杂因素进行了调整。在835594人年的随访中，我们记录了271例新发白癜风病例。左臂至少有一个直径大于3毫米痣的女性患白癜风的风险更高（风险比 = 1.37，95%置信区间 = 1.02 - 1.83）。此外，晒黑能力较好的女性患白癜风的风险更高（风险比 = 2.59，95%置信区间 = 1.21 - 5.54），经历过至少一次水疱性晒伤的女性也是如此（风险比 = 2.17，95%置信区间 = 1.15 - 4.10）。在这项研究中，上肢有痣、较高的晒黑能力以及水疱性晒伤史与白人女性群体中患白癜风的较高风险相关。
