Kim H S, Kim H J, Hong E S, Kim K B, Lee J D, Kang T U, Ahn H S
Department of Dermatology, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Biomedicine and Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Br J Dermatol. 2020 Apr;182(4):907-915. doi: 10.1111/bjd.18247. Epub 2019 Sep 18.
While studies report a lower incidence of skin cancer in white patients with vitiligo compared with controls, the skin cancer incidence in Asian patients with vitiligo is unknown.
To quantify the incidence of melanoma and nonmelanoma skin cancer (NMSC) in Korean patients with vitiligo and compare it with matched nonvitiligo controls.
A retrospective matched cohort study was performed with 131 245 incident vitiligo cases and 2 624 900 age- and sex-matched (1 : 20) controls at index date, who were selected from the Korean National Health Insurance database between January 2005 and December 2017. Stratified Cox proportional hazards regression (stratified by sex, birth year and index year) was used to calculate the hazard ratio (HR) of skin cancer in patients with vitiligo.
Patients with vitiligo were followed up for a mean duration of 6·34 years compared with a follow-up period of 6·27 years for matched controls. Ultraviolet (UV) treatment-adjusted HR for melanoma in patients with vitiligo was 3·32 [95% confidence interval (CI) 2·29-4·81] and 1·29 (95% CI 1·06-1·56) for NMSC. The HRs for melanoma and NMSC in the vitiligo population without a history of UV treatment were 3·37 (95% CI 2·32-4·90) and 1·35 (95% CI 1·11-1·64), respectively.
In contrast to white patients with vitiligo, the risk of skin cancer was increased in the Korean vitiligo population. However, it is noteworthy that the skin cancer incidence in Korean patients with vitiligo was lower than that of their white counterparts. Owing to possible ethnic differences in the susceptibility to skin cancer, skin cancer surveillance in the vitiligo population may be adjusted for race. What's already known about this topic? Prior studies have reported a lower incidence of melanoma and nonmelanoma skin cancer (NMSC) in white patients with vitiligo compared with nonvitiligo controls. The skin cancer incidence in Asian patients with vitiligo is unknown. What does this study add? In contrast to white patients, the risk of both melanoma and NMSC was increased in Korean patients with vitiligo compared with controls. Owing to possible ethnic differences in susceptibility to skin cancer, skin cancer surveillance in the vitiligo population should be adjusted for race.
虽然研究报告称，白癜风白人患者的皮肤癌发病率低于对照组，但白癜风亚洲患者的皮肤癌发病率尚不清楚。
量化韩国白癜风患者中黑色素瘤和非黑色素瘤皮肤癌（NMSC）的发病率，并与匹配的非白癜风对照组进行比较。
进行了一项回顾性匹配队列研究，纳入2005年1月至2017年12月期间从韩国国民健康保险数据库中选取的131245例新发白癜风病例以及2624900例年龄和性别匹配（1:20）的对照。采用分层Cox比例风险回归（按性别、出生年份和索引年份分层）计算白癜风患者皮肤癌的风险比（HR）。
白癜风患者的平均随访时间为6.34年，而匹配对照组的随访时间为6.27年。白癜风患者黑色素瘤经紫外线（UV）治疗调整后的HR为3.32[95%置信区间（CI）2.29 - 4.81]，NMSC为1.29（95%CI 1.06 - 1.56）。无UV治疗史的白癜风人群中黑色素瘤和NMSC的HR分别为3.37（95%CI 2.32 - 4.90）和1.35（95%CI 1.11 - 1.64）。
与白癜风白人患者不同，韩国白癜风人群患皮肤癌的风险增加。然而，值得注意的是，韩国白癜风患者的皮肤癌发病率低于白人患者。由于皮肤癌易感性可能存在种族差异，白癜风人群的皮肤癌监测可能需要根据种族进行调整。关于该主题已知的信息有哪些？先前的研究报告称，与非白癜风对照组相比，白癜风白人患者的黑色素瘤和非黑色素瘤皮肤癌（NMSC）发病率较低。白癜风亚洲患者的皮肤癌发病率尚不清楚。本研究增加了什么内容？与白人患者不同，韩国白癜风患者患黑色素瘤和NMSC的风险均高于对照组。由于皮肤癌易感性可能存在种族差异，白癜风人群的皮肤癌监测应根据种族进行调整。
