Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, South Korea, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.
Department of Medical Informatics, Jeonbuk National University, Jeonju, South Korea.
Eur J Dermatol. 2024 Apr 1;34(2):150-157. doi: 10.1684/ejd.2024.4646.
As recent sporadic case reports of newly developed vitiligo after SARS-CoV-2 infection or vaccination have been -published, a convincing large-scale study addressing this association is warranted. To investigate the association between SARS-CoV-2 infection or vaccination and vitiligo using the Korean National Health Insurance Service database. SARS-CoV-2-positive patients and those vaccinated against SARS-CoV-2 were recruited. In studies 1 and 2, control groups were selected based on 1:1 propensity score matching with vaccinated and SARS-CoV-2-positive patients, respectively. The occurrence of vitiligo was the main outcome. Each individual was monitored for six months. The hazard ratio (HR) for vitiligo was calculated using the Cox proportional hazards model. In study 1, the incidence of vitiligo in the vaccination group was 2.22-fold higher than that in the non-vaccination group (adjusted HR [aHR]: 2.22; 95% confidence interval [CI]: 1.54-3.19). Rheumatoid arthritis was a risk factor for vitiligo (aHR: 1.99; 95% CI: 1.12-3.54). Conversely, two factors associated with decreased incidence of vitiligo were male sex (aHR: 0.58; 95% CI: 0.40-0.82) and rural residency (aHR: 0.68; 95% CI: 0.49-0.96). In study 2, the incidence of newly-diagnosed vitiligo was not significantly different between SARS-CoV-2-positive patients and uninfected controls (aHR: 0.95; 95% CI: 0.51-1.78). SARS-CoV-2 vaccination may increase the risk of developing vitiligo in South Korea, although additional studies in other countries or with extended periods are needed. Clinicians should be aware of the impact of SARS-CoV-2 infection and vaccination on autoimmune skin diseases, including vitiligo.
由于最近有报道称 SARS-CoV-2 感染或接种后新出现的白癜风病例[1-3]，因此需要进行一项有说服力的大规模研究来探讨这种关联。本研究使用韩国国家健康保险服务数据库，调查 SARS-CoV-2 感染或接种与白癜风之间的关联。招募了 SARS-CoV-2 阳性患者和接种 SARS-CoV-2 疫苗的患者。在研究 1 和 2 中，对照组分别基于与接种和 SARS-CoV-2 阳性患者的 1:1 倾向评分匹配进行选择。主要结局为白癜风的发生。每个个体都被监测了 6 个月。使用 Cox 比例风险模型计算白癜风的风险比（HR）。在研究 1 中，接种组白癜风的发生率是未接种组的 2.22 倍（调整后的 HR[aHR]：2.22；95%置信区间[CI]：1.54-3.19）。类风湿性关节炎是白癜风的一个危险因素（aHR：1.99；95%CI：1.12-3.54）。相反，与白癜风发病率降低相关的两个因素是男性（aHR：0.58；95%CI：0.40-0.82）和农村居住（aHR：0.68；95%CI：0.49-0.96）。在研究 2 中，SARS-CoV-2 阳性患者与未感染对照者新发白癜风的发生率无显著差异（aHR：0.95；95%CI：0.51-1.78）。在韩国，SARS-CoV-2 疫苗接种可能会增加白癜风的发病风险，尽管还需要在其他国家或延长时间进行更多的研究。临床医生应意识到 SARS-CoV-2 感染和接种对包括白癜风在内的自身免疫性皮肤病的影响。
