Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
Dermatol Ther. 2021 Jul;34(4):e15014. doi: 10.1111/dth.15014. Epub 2021 Jun 16.
Due to the COVID-19 pandemic, routine treatments are delayed to some extent and their negative impacts have been widely reported. However, virtually nothing is known about vitiligo in the context of COVID-19. Therefore, we analyzed treatment delays and its impact on vitiligo, aiming to provide suggestions on vitiligo management within this special period. We performed a retrospective cohort study on 322 patients who visited our clinics at least 2 times from January to December 2020, and their medical records and photographs were reviewed. Patients were divided into normal (n = 155) and late group (n = 167) based on whether experienced treatment delays. As for the active cases, the late group showed higher progression rate than normal group (35 of 86 [40.7%] vs. 10 of 81 [12.3%]; p = 0.002). Moreover, we observed higher recurrence rate in delay group than those of normal group (26 of 81[32.1%] vs. 9 of 74 [12.2%]; p = 0.018) among stable cases. Further univariate and multivariate analysis determined treatment delays as the most important independent risk factor for disease progression and recurrence, and maintenance therapy (>2 years) as a protective factor against recurrence. This study, for the first time, revealed the independent adverse impact of treatment delays on the progression and recurrence of vitiligo and indicated the significance of continuous treatment for halting progression and long-term maintenance therapy for preventing recurrence for vitiligo, which should be highly valued in the management of vitiligo during the COVID-19 pandemic.
由于 COVID-19 大流行,常规治疗在某种程度上被延迟,其负面影响已被广泛报道。然而,在 COVID-19 背景下,关于白癜风的研究几乎没有。因此,我们分析了治疗延迟及其对白癜风的影响,旨在为这一特殊时期的白癜风管理提供建议。我们对 2020 年 1 月至 12 月期间至少两次来我院就诊的 322 例患者进行了回顾性队列研究,对其病历和照片进行了回顾。根据是否经历治疗延迟,患者被分为正常组(n=155)和延迟组(n=167)。对于活动期患者,延迟组的进展率高于正常组(35/86 [40.7%] 比 10/81 [12.3%];p=0.002)。此外,我们观察到稳定期患者中延迟组的复发率高于正常组(26/81[32.1%] 比 9/74 [12.2%];p=0.018)。进一步的单因素和多因素分析确定治疗延迟是疾病进展和复发的最重要独立危险因素,维持治疗(>2 年)是预防复发的保护因素。这项研究首次揭示了治疗延迟对白癜风进展和复发的独立不良影响,并表明持续治疗对阻止进展和长期维持治疗对预防复发的重要性,这在 COVID-19 大流行期间的白癜风管理中应高度重视。