Current Dermatology Reports

, Volume 4, Issue 1, pp 36–43 | Cite as

The Epidemiology of Vitiligo

Epidemiology (JI Silverberg, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Epidemiology

Abstract

Vitiligo is a common condition seen in a dermatology office, which has a variety of comorbidities. Worldwide, the prevalence of vitiligo ranges from 0.4 to 2.0 %, with regions of greater or lesser prevalence. Most studies demonstrate slightly greater prevalence in females and 50 % onset in childhood, but exceptions to these rules exist. Childhood vitiligo has been associated with atopic diathesis, halo nevi, and family history of vitiligo and autoimmunity. Post-pubescent vitiligo has been associated with greater acrofacial disease and thyroid disease, and early data supports reduced non-melanoma and melanoma skin cancer risk. Disease severity is inversely proportional to distance from the equator, and birthplace outside the USA may be somewhat protective against severe disease. This article reviews the epidemiology of vitiligo and the epidemiologic relationship of vitiligo to comorbid diseases and family history, with a focus on recent literature.

Keywords

Dermatology Pediatrics Post-pubescent Comorbid diseases Family history Literature review 

References

  1. 1.
    Silverberg NB. Recent advances in childhood vitiligo. Clin Dermatol. 2014;32:524–30.CrossRefPubMedGoogle Scholar
  2. 2.
    Ezzedine K. Latent class analysis of a series of 717 patients with vitiligo allows the identification of two clinical subtypes. Pigment Cell Melanoma Res. 2014;27:134–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Agarwal S, Gupta S, Ojha A, Sinha R. Childhood vitiligo: clinicoepidemiologic profile of 268 children from the Kumaun region of Uttarakhand. India Pediatr Dermatol. 2013;30:348–53.CrossRefGoogle Scholar
  4. 4.
    Kyriakis KP, Palamaras I, Tsele E, Michailides C, Terzoudi S. Case detection rates of vitiligo by gender and age. Int J Dermatol. 2009;48:328–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Howitz J, Brodthagen H, Schwartz M, et al. Prevalence of vitiligo. Epidemiological survey on the Isle of Bornholm, Denmark. Arch Dermatol. 1977;113:47–52.CrossRefPubMedGoogle Scholar
  6. 6.
    Vora RV, Patel BB, Chaudhary AH, Mehta MJ, Pilani AP. A clinical study of vitiligo in a rural set up of Gujarat. Ind J Comm Med. 2014;39:143–6.CrossRefGoogle Scholar
  7. 7.
    Nejad SB, Qadim HH, Nazeman L, Fadaii R, Goldust M. Frequency of autoimmune diseases in those suffering from vitiligo in comparison with normal population. Pak J Biol Sci. 2013;16:570–4.CrossRefPubMedGoogle Scholar
  8. 8.
    Nunes DH, Esser LM. Vitiligo epidemiological profile and the association with thyroid disease. An Bras Dermatol. 2011;86:241–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Alissa A, Al Eisa A, Huma R, Mulekar S. Vitiligo—epidemiological study of 4134 patients at the National Center for Vitiligo and Psoriasis in Central Saudi Arabia. Saudi Med J. 2011;32:1291–6.PubMedGoogle Scholar
  10. 10.
    Agarwal S, Gupta S, Ojha A, Sinha R. Childhood vitiligo: clinicoepidemiologic profile of 268 children from the Kumaun region of Uttarakhand. India Pediatr Dermatol. 2013;30:348–53.CrossRefGoogle Scholar
  11. 11.
    Radtke MA, Schäfer I, Gajur AI, Augustin M. Clinical features and treatment outcomes of vitiligo from the patients’ perspective: results of a national survey in Germany. Dermatology. 2010;220:194–200.CrossRefPubMedGoogle Scholar
  12. 12.
    Ayanlowo O, Olumide YM, Akinkugbe A, Ahamneze N, Otike-Odibi BI, Ekpudu VI, et al. Characteristics of vitiligo in Lagos. Nigeria West Afr J Med. 2009;28:118–21.Google Scholar
  13. 13.
    Romero FR, Romero AW, Almeida RM, Oliveira Jr FC, Filho Jr RT. Prevalence and risk factors for penile lesions/anomalies in a cohort of Brazilian men ≥40 years of age. Int Braz J Urol. 2013;39:55–62.CrossRefPubMedGoogle Scholar
  14. 14.
    Boisseau-Garsaud AM, Garsaud P, Calès-Quist D, Hélénon R, Quénéhervé C, Claire R. Epidemiology of vitiligo in the French West Indies (Isle of Martinique). Int J Dermatol. 2000;39:18–20.CrossRefPubMedGoogle Scholar
  15. 15.
    Krüger C, Schallreuter KU. A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Int J Dermatol. 2012;51:1206–12.CrossRefPubMedGoogle Scholar
  16. 16.
    Jacobsen DL, Gange SJ, Rose NR, Graham NMH. Epidemiology and estimated population burden of selected autoimmune disease in the United States. Clin Immmunol Immunopath. 1997;84:223–43.CrossRefGoogle Scholar
  17. 17.
    Taylor A, Pawaskar M, Taylor SL, Balkrishnan R, Feldman SR. J Cosmet Dermatol. 2008;7:14168.CrossRefGoogle Scholar
  18. 18.
    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;16:208–14.CrossRefPubMedGoogle Scholar
  19. 19.
    Paradisi A, Tabolli S, Didona B, Sobrino L, Russo N, Abeni D. Markedly reduced incidence of melanoma and nonmelanoma skin cancer in a nonconcurrent cohort of 10,040 patients with vitiligo. J Am Acad Dermatol. 2014;71:1110–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Shrestha R, Shrestha D, Dhakal AK, Shakya A, Shah SC, Shakya H. Spectrum of pediatric dermatoses in tertiary care center in Nepal. Nepal Med Coll J. 2012;14:146–8.PubMedGoogle Scholar
  21. 21.
    Chen GY, Cheng YW, Wang CY, Hsu TJ, Hsu MM, Yang PT, et al. Prevalence of skin diseases among schoolchildren in Magong, Penghu, Taiwan: a community-based clinical survey. J Formos Med Assoc. 2008;107:21–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Yamamah GA, Emam HM, Abdelhamid MF, Elsaie ML, Shehata H, Farid T, et al. Epidemiologic study of dermatologic disorders among children in South Sinai. Egypt Int J Dermatol. 2012;51:1180–5.CrossRefGoogle Scholar
  23. 23.
    Lerner B. Vitiligo. J Investig Dermatol. 1959;32:295–310.Google Scholar
  24. 24.
    Hexsel CL, Eide MJ, Johnson CC, Krajenta R, Jacobsen G, Hamzavi I, et al. Incidence of nonmelanoma skin cancer in a cohort of patients with vitiligo. J Am Acad Dermatol. 2009;60:929–33.CrossRefPubMedGoogle Scholar
  25. 25.
    Pajvani U, Ahmad N, Wiley A, Levy RM, Kundu R, Mancini AJ, et al. The relationship between family medical history and childhood vitiligo. J Am Acad Dermatol. 2006;55:238–44.CrossRefPubMedGoogle Scholar
  26. 26.
    Sheth VM, Guo Y, Qureshi AA. Comorbidities associated with vitiligo: a ten-year retrospective study. Dermatology. 2013;227:311–5.CrossRefPubMedGoogle Scholar
  27. 27.
    Kar PK. Vitiligo: a study of 120 cases. Indian J Dermatol Venereol Leprol. 2001;67:302–4.PubMedGoogle Scholar
  28. 28.
    Jaigirdar MQ, Alam SM, Maidul AZ. Clinical presentation of vitiligo. Mymensingh Med J. 2002;11:79–81.PubMedGoogle Scholar
  29. 29.
    Cho S, Kang HC, Hahm JH. Characteristics of vitiligo in Korean children. Pediatr Dermatol. 2000;17:189–93.CrossRefPubMedGoogle Scholar
  30. 30.
    Sun X, Xu A, Wei X, Ouyang J, Lu L, Chen M, et al. Genetic epidemiology of vitiligo: a study of 815 probands and their families from south China. Int J Dermatol. 2006;45:1176–81.CrossRefPubMedGoogle Scholar
  31. 31.
    Poojary SA. Vitiligo and associated autoimmune disorders: a retrospective hospital-based study in Mumbai. India Allergol Immunopathol (Madr). 2011;39:356–61.CrossRefGoogle Scholar
  32. 32.
    Alzolibani A. Genetic epidemiology and heritability of vitiligo in the Qassim region of Saudi Arabia. Acta Dermatovenerol Alp Pannonica Adriat. 2009;18:119.PubMedGoogle Scholar
  33. 33.
    Marinho Fde S, Cirino PV, Fernandes NC. Clinical epidemiological profile of vitiligo in children and adolescents. An Bras Dermatol. 2013;88:1026–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Nunes DH, Esser LM. Vitiligo epidemiological profile and the association with thyroid disease. An Bras Dermatol. 2011;86:241–8.CrossRefPubMedGoogle Scholar
  35. 35.
    Habib A, Raza N. Clinical pattern of vitiligo. J Coll Physicians Surg Pak. 2012;22:61–2.PubMedGoogle Scholar
  36. 36.
    Shankar DS, Shashikala K, Madala R. Clinical patterns of vitiligo and its associated co morbidities: a prospective controlled cross-sectional study in South India. Indian Dermatol Online J. 2012;3:114–8.CrossRefPubMedCentralPubMedGoogle Scholar
  37. 37.
    Al-Refu K. Vitiligo in children: a clinical-epidemiologic study in Jordan. Pediatr Dermatol. 2012;29:114–5.CrossRefPubMedGoogle Scholar
  38. 38.
    Nicolaidou E, Antoniou C, Miniati A, Lagogianni E, Matekovits A, Stratigos A, et al. Childhood- and later-onset vitiligo have diverse epidemiologic and clinical characteristics. J Am Acad Dermatol. 2012;66:954–8.CrossRefPubMedGoogle Scholar
  39. 39.
    Halder RM, Grimes PE, Cowan CA, Enterline JA, Chakrabarti SG, Kenney Jr JA. Childhood vitiligo. J Am Acad Dermatol. 1987;16(5 Pt 1):948–54.CrossRefPubMedGoogle Scholar
  40. 40.
    Mazereeuw-Hautier J, Bezio S, Mahe E, Bodemer C, Eschard C, Viseux V, et al. Segmental and nonsegmental childhood vitiligo has distinct clinical characteristics: a prospective observational study. J Am Acad Dermatol. 2010;62:945–9.CrossRefPubMedGoogle Scholar
  41. 41.
    Silverberg N. Segmental vitiligo may not be associated with risk of autoimmune thyroiditis. Skinmed. 2011;9:329–30.PubMedGoogle Scholar
  42. 42.
    Pagovich OE, Silverberg JI, Freilich E, Silverberg NB. Thyroid abnormalities in pediatric patients with vitiligo in New York City. Cutis. 2008;81:463–6.PubMedGoogle Scholar
  43. 43.
    Ezzedine K, Diallo A, Léauté-Labrèze C, Séneschal J, Prey S, Ballanger F, et al. Halo naevi and leukotrichia are strong predictors of the passage to mixed vitiligo in a subgroup of segmental vitiligo. Br J Dermatol. 2012;166:539–44.CrossRefPubMedGoogle Scholar
  44. 44.
    Narita T, Oiso N, Fukai K, Kabashima K, Kawada A, Suzuki T. Generalized vitiligo and associated autoimmune diseases in Japanese patients and their families. Allergol Int. 2011;60:505–8.CrossRefPubMedGoogle Scholar
  45. 45.
    Gönül M, Cakmak SK, Oğuz D, Gül U, Kiliç S. Profile of vitiligo patients attending a training and research hospital in Central Anatolia: a retrospective study. J Dermatol. 2012;39:156–9.CrossRefPubMedGoogle Scholar
  46. 46.
    Poojary SA. Vitiligo and associated autoimmune disorders: a retrospective hospital-based study in Mumbai. India Allergol Immunopathol (Madr). 2011;39:356–61.CrossRefGoogle Scholar
  47. 47.
    Akay BN, Bozkir M, Anadolu Y, Gullu S. Epidemiology of vitiligo, associated autoimmune diseases and audiological abnormalities: Ankara study of 80 patients in Turkey. J Eur Acad Dermatol Venereol. 2010;24:1144–50.CrossRefPubMedGoogle Scholar
  48. 48.
    Iacovelli P, Sinagra JL, Vidolin AP, Marenda S, Capitanio B, Leone G, et al. Relevance of thyroiditis and of other autoimmune diseases in children with vitiligo. Dermatology. 2005;210:26–30.CrossRefPubMedGoogle Scholar
  49. 49.
    Prćić S, Djuran V, Katanić D, Vlaški J, Gajinov Z. Vitiligo and thyroid dysfunction in children and adolescents. Acta Dermatovenerol Croat. 2011;19:248–54.PubMedGoogle Scholar
  50. 50.
    Vrijman C, Kroon MW, Limpens J, Leeflang MM, Luiten RM, van der Veen JP, et al. The prevalence of thyroid disease in patients with vitiligo: a systematic review. Br J Dermatol. 2012;167:1224–35.CrossRefPubMedGoogle Scholar
  51. 51.
    Uncu S, Yaylı S, Bahadır S, Okten A, Alpay K. Relevance of autoimmune thyroiditis in children and adolescents with vitiligo. Int J Dermatol. 2011;50:175–9.CrossRefPubMedGoogle Scholar
  52. 52.
    Fleissig E, Gross M, Ophir I, Elidan J, Bdolah-Abram T, Ingber A. Risk of sensorineural hearing loss in patients with vitiligo. Audiol Neurootol. 2013;18:240–6.CrossRefPubMedGoogle Scholar
  53. 53.
    Mahdi P, Rouzbahani M, Amali A, Rezaii Khiabanlu S, Kamali M. Audiological manifestations in vitiligo patients. Iran J Otorhinolaryngol. 2012;24:35–40.PubMedCentralPubMedGoogle Scholar
  54. 54.
    Kalkanli N, Kalkanli S. Classification and comparative study of vitiligo in southeast of Turkey with biochemical and immunological parameters. Clin Ter. 2013;164:397–402.PubMedGoogle Scholar
  55. 55.
    Afkhami-Ardekani M, Ghadiri-Anari A, Ebrahimzadeh-Ardakani M, Zaji N. Prevalence of vitiligo among type 2 diabetic patients in an Iranian population. Int J Dermatol. 2014;53:956–8.CrossRefPubMedGoogle Scholar
  56. 56.
    Boelaert K, Newby PR, Simmonds MJ, Holder RL, Carr-Smith JD, Heward JM, et al. Prevalence and relative risk of other autoimmune diseases in subjects with autoimmune thyroid disease. Am J Med. 2010;123:183. e1-9.CrossRefPubMedGoogle Scholar
  57. 57.
    Prindaville B, Rivkees SA. Incidence of vitiligo in children with Graves’ disease and Hashimoto’s thyroiditis. Int J Pediatr Endocrinol. 2011;2011:18.CrossRefPubMedCentralPubMedGoogle Scholar
  58. 58.
    Michou L, Rat AC, Lasbleiz S, Bardin T, Cornélis F. Prevalence and distribution of autoimmune diseases in 368 rheumatoid arthritis families. J Rheumatol. 2008;35:790–6.PubMedGoogle Scholar
  59. 59.
    Alenizi DA. Consanguinity pattern and heritability of vitiligo in Arar, Saudi Arabia. J Fam Comm Med. 2014;21:13–6.CrossRefGoogle Scholar
  60. 60.
    Wang Y, Chan C-C. Gender differences in Vogt-Koyanagi-Harada disease and sympathetic ophthalmia. J Ophthalmol. 2014.Google Scholar
  61. 61.
    Kanwar AJ, Mahajan R, Parsad D. Effect of age at onset on disease characteristics in vitiligo. J Cutan Med Surg. 2013;17:253–8.PubMedGoogle Scholar
  62. 62.
    Silverberg JI, Silverberg NB. Association between vitiligo and atopic disorders: a pilot study. JAMA Dermatol. 2013;149:983–86.PubMedGoogle Scholar
  63. 63.
    Mohan GC, Silverberg JI. Association of vitiligo and alopecia areata with atopic dermatitis: a systematic review and meta-analysis. JAMA Dermatol. 2014. doi:10.1001/jamadermatol.2014.3324.PubMedGoogle Scholar
  64. 64.
    Rodríguez-Martín M, de Paz NM, Mehtani P, Ferrer PC, Eliche MP, Martín BR, et al. Patients with vitiligo present fewer cardiovascular risk factors: results from a case-control study. J Eur Acad Dermatol Venereol. 2013;27:124–5.CrossRefPubMedGoogle Scholar
  65. 65.
    Schaefer I, Augustin M, Spehr C, Reusch M, Kornek T. Prevalence and risk factors of actinic keratoses in Germany—analysis of multisource data. J Eur Acad Dermatol Venereol. 2014;28:309–13.CrossRefPubMedGoogle Scholar
  66. 66.
    Teulings HE, Overkamp M, Ceylan E, et al. Decreased risk of melanoma and non-melanoma skin cancer in patients with vitiligo: a survey among 1307 patients and their partners. Br J Dermatol. 2013;168:162–71.CrossRefPubMedGoogle Scholar
  67. 67.
    Silverberg JI, Silverberg NB. Quality of life impairment in children and adolescents with vitiligo. Pediatr Dermatol. 2014;31:309–18.CrossRefPubMedGoogle Scholar
  68. 68.
    Silverberg JI, Silverberg NB. Association between vitiligo extent and distribution and quality-of-life impairment. JAMA Dermatol. 2013;149:159–64.CrossRefPubMedGoogle Scholar
  69. 69.
    Dolatshahi M, Ghazi P, Feizy V, Hemami MR. Life quality assessment among patients with vitiligo: comparison of married and single patients in Iran. Indian J Dermatol Venereol Leprol. 2008;74:700.PubMedGoogle Scholar
  70. 70.
    Bin Saif GA, Al-Balbeesi AO, Binshabaib R, Alsaad D, Kwatra SG, Alzolibani AA, et al. Quality of life in family members of vitiligo patients: a questionnaire study in Saudi Arabia. Am J Clin Dermatol. 2013;14:489–95.CrossRefPubMedGoogle Scholar
  71. 71.
    Tejada Cdos S, Mendoza-Sassi RA, Almeida Jr HL, Figueiredo PN, Tejada VF. Impact on the quality of life of dermatological patients in southern Brazil. An Bras Dermatol. 2011;86:1113–21.PubMedGoogle Scholar
  72. 72.
    Arýcan O, Koç K, Ersoy L. Clinical characteristics in 113 Turkish vitiligo patients. Acta Dermatovenerol Alp Pannonica Adriat. 2008;17:129–32.PubMedGoogle Scholar
  73. 73.
    Silverberg JI, Silverberg NB. Association between vitiligo and atopic disorders: a pilot study. JAMA Dermatol. 2013;149:983–86.PubMedGoogle Scholar
  74. 74.
    Ezzedine K, Diallo A, Léauté-Labrèze C, Séneschal J, Prey S, Ballanger F, et al. Pre- vs. post-pubertal onset of vitiligo: multivariate analysis indicates atopic diathesis association in pre-pubertal onset vitiligo. Br J Dermatol. 2012;167:490–5.CrossRefPubMedGoogle Scholar
  75. 75.
    Silverberg JI, Reja M, Silverberg NB. Regional variation of and association of US birthplace with vitiligo extent. JAMA Dermatol. 2014;150:1298–305.CrossRefPubMedGoogle Scholar
  76. 76.
    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;62:937–41.CrossRefPubMedGoogle Scholar
  77. 77.
    Silverberg JI, Silverberg NB. Clinical features of vitiligo associated with comorbid autoimmune disease: a prospective survey. J Am Acad Dermatol. 2013;69:824–6.CrossRefPubMedGoogle Scholar
  78. 78.
    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;62:937–41.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Pediatric Dermatology, Mt. Sinai St. Luke’s-Roosevelt Hospital CenterNew YorkUSA

Personalised recommendations