Prevalence of Multiple Sclerosis in Vitiligo Patients and Their First-Degree Relatives: Two Diseases with Similarities in Pathogenesis and Treatment

Prevalence of Multiple Sclerosis in Vitiligo Patients and Their First-Degree Relatives: Two Diseases with Similarities in Pathogenesis and Treatment

Authors

  • Mohammadreza Kavyani Department of Dermatology; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Vahideh Lajevardi Department of Dermatology; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Maryam Ghiasi Department of Dermatology; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Maryam Daneshpazhooh Department of Dermatology; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Sama Heidari Department of Dermatology; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Amir Teimourpour Department of Dermatology; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Kamran Balighi Department of Dermatology; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran

Keywords:

autoimmune, multiple sclerosis, neurological, prevalence, vitiligo

Abstract

Introduction: Vitiligo is a common pigmentation disorder manifested by white macules and patches. It is accompanied by some autoimmune and neurological diseases. Recently, it has been suggested that multiple sclerosis (MS) is more common in vitiligo patients and that they have a higher risk of developing MS during their lifetime.

Objectives: In this study, we aimed to determine the prevalence of MS in patients with vitiligo and their first-degree relatives and compare it with the prevalence in the population.

Methods: In this cross-sectional study, data were consecutively collected from patients referred to Razi Hospital from March 2020 to December 2021.

Results: 709 patients with vitiligo participated in this study, and 15 reported a history of MS (2.12%, 95% CI: 1.06-3.17%). This rate was significantly higher than the prevalence of MS in the average population of Tehran (p < 0.001). Of the 2886 first-degree relatives of the patients, 10 had MS (0.35%, 95% CI: 0.13-0.56%), which was higher than the prevalence of MS, yet not statistically significant.

Conclusions: A significant association between vitiligo and MS was observed, which should be of clinical and therapeutic importance. However, the prevalence of MS in first-degree relatives of vitiligo patients was higher than the average rate, yet not statistically significant.

References

Elbuluk N, Ezzedine K. Quality of life, burden of disease, co-morbidities, and systemic effects in vitiligo patients. Dermatol Clin. 2017;35(2):117-128.

Alkhateeb A, Fain PR, Thody A, Bennett DC, Spritz RA. Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Res. 2003;16(3):208-214.

Gandhi K, Ezzedine K, Anastassopoulos KP, et al. Prevalence of vitiligo among adults in the United States. JAMA dermatology. 2022;158(1):43-50.

Rodrigues M, Ezzedine K, Hamzavi I, Pandya AG, Harris JE, Group VW. New discoveries in the pathogenesis and classification of vitiligo. J Am Acad Dermatol. 2017;77(1):1-13.

Gill L, Zarbo A, Isedeh P, Jacobsen G, Lim HW, Hamzavi I. Comorbid autoimmune diseases in patients with vitiligo: a cross-sectional study. J Am Acad Dermatol. 2016;74(2):295-302.

Shen MH, Ng CY, Chang KH, Chi CC. Association of multiple sclerosis with vitiligo: a systematic review and meta-analysis. Sci Rep. 2020;10(1):1-7.

Hadi A, Wang JF, Uppal P, Penn LA, Elbuluk N. Comorbid diseases of vitiligo: a 10-year cross-sectional retrospective study of an urban US population. J Am Acad Dermatol. 2020;82(3):628-633.

Ruck T, Pfeuffer S, Schulte-Mecklenbeck A, et al. Vitiligo after alemtuzumab treatment: secondary autoimmunity is not all about B cells. Neurology. 2018;91(24):e2233-e2237.

Silverberg JI, Silverberg NB. Clinical features of vitiligo associated with comorbid autoimmune disease: a prospective survey. J Am Acad Dermatol. 2013;69(5):824-826.

Amini P, Almasi-Hashiani A, Sahraian MA, Najafi M, Eskandarieh S. Multiple sclerosis projection in Tehran, Iran using Bayesian structural time series. BMC Neurol. 2021;21(1):1-6.

Kundu R V, Mhlaba JM, Rangel SM, Le Poole IC. The convergence theory for vitiligo: A reappraisal. Exp Dermatol. 2019;28(6):647-655.

Al Abadie MS, Gawkrodger DJ. Integrating neuronal involvement into the immune and genetic paradigm of vitiligo. Clin Exp Dermatol. 2021;46(4):646-650.

Lotti T, D’Erme AM, Hercogová J. The role of neuropeptides in the control of regional immunity. Clin Dermatol. 2014;32(5):633-645.

Gauthier Y, Benzekri L. The neurogenic hypothesis in segmental vitiligo. In: Vitiligo. Springer; 2010:302-305.

Tegta GR, Thakur S, Negi A, Verma G, Gupta M, Verma K. Von Recklinghausen Disease with Vitiligo: A Rare Association.

Deretzi G, Kountouras J, Polyzos SA, et al. Polyautoimmunity in a Greek cohort of multiple sclerosis. Acta Neurol Scand. 2015;131(4):225-230.

Kriegel MA, Manson JE, Costenbader KH. Does vitamin D affect risk of developing autoimmune disease?: a systematic review. In: Seminars in Arthritis and Rheumatism. Vol 40. Elsevier; 2011:512-531.

Harris JE. Cellular stress and innate inflammation in organ‐specific autoimmunity: lessons learned from vitiligo. Immunol Rev. 2016;269(1):11-25.

Zarobkiewicz MK, Kowalska W, Morawska I, Halczuk P, Rejdak K, Bojarska-Junak A. IL-15 Is Overexpressed in γδ T Cells and Correlates with Disease Severity in Relapsing-Remitting Multiple Sclerosis. J Clin Med. 2021;10(18):4174.

Tokura Y, Phadungsaksawasdi P, Kurihara K, Fujiyama T, Honda T. Pathophysiology of skin resident memory T cells. Front Immunol. 2021;11:618897.

Marrie RA, Reider N, Cohen J, et al. A systematic review of the incidence and prevalence of autoimmune disease in multiple sclerosis. Mult Scler J. 2015;21(3):282-293.

Hart PH, Norval M, Byrne SN, Rhodes LE. Exposure to ultraviolet radiation in the modulation of human diseases. Annu Rev Pathol. 2019;14:55-81.

Silverberg JI, Silverberg AI, Malka E, Silverberg NB. A pilot study assessing the role of 25 hydroxy vitamin D levels in patients with vitiligo vulgaris. J Am Acad Dermatol. 2010;62(6):937-941.

Lee H, Lee MH, Lee DY, et al. Prevalence of vitiligo and associated comorbidities in Korea. Yonsei Med J. 2015;56(3):719-725.

Amiri M. Multiple sclerosis in Iran: An epidemiological update with focus on air pollution debate. J Clin Transl Res. 2021;7(1):49.

Eskandarieh S, Heydarpour P, Elhami SR, Sahraian MA. Prevalence and incidence of multiple sclerosis in Tehran, Iran. Iran J Public Health. 2017;46(5):699.

Hosseinzadeh A, Sedighi B, Kermanchi J, Heidari M, Haghdoost AA. Is the sharp increasing trend of multiple sclerosis incidence real in Iran? BMC Neurol. 2021;21(1):1-5.

Mokhtarpour Neilagh A, Alizadeh F, Aghazadeh Barenji M, Behrouz Sharif S, Sedokani A. Different characteristics of early-onset vitiligo versus lateonset vitiligo. Iran J Dermatology. 2020;23(4):132-136.

Bergqvist C, Ezzedine K. Vitiligo: a review. Dermatology. 2020;236(6):571-592.

Speeckaert R, van Geel N. Distribution patterns in generalized vitiligo. J Eur Acad Dermatology Venereol. 2014;28(6):755-762.

Nociti V, Romozzi M. Multiple Sclerosis and Autoimmune Comorbidities. J Pers Med. 2022;12(11). doi:10.3390/jpm12111828

Marrie RA, Fisk JD, Fitzgerald K, et al. Etiology, effects and management of comorbidities in multiple sclerosis: recent advances. Front Immunol. 2023;14(May):1-15. doi:10.3389/fimmu.2023.1197195

Rato ML, Santos M, de Sá J, Ferreira J. Comorbid autoimmune disorders in people with multiple sclerosis: A retrospective cohort study. J Neuroimmunol. 2023;385:578226.

Rauma I, Mustonen T, Seppä JM, et al. Safety of alemtuzumab in a nationwide cohort of Finnish multiple sclerosis patients. J Neurol. 2022;269(2):824-835. doi:10.1007/s00415-021-10664-w

Kocer B, Nazliel B, Oztas M, Batur HZ. Vitiligo and multiple sclerosis in a patient treated with interferon beta-1a: a case report. Eur J Neurol. 2009;16(4):e78-9.

Downloads

Published

2024-07-31

How to Cite

1.
Prevalence of Multiple Sclerosis in Vitiligo Patients and Their First-Degree Relatives: Two Diseases with Similarities in Pathogenesis and Treatment. Dermatol Pract Concept [Internet]. 2024 Jul. 31 [cited 2024 Dec. 5];14(3):e2024a103. Available from: https://www.dpcj.org/index.php/dpc/article/view/3630

Share