Investigating the epidemiological relationship between vitiligo and psoriasis: a population-based study.

BACKGROUND: The association of vitiligo with psoriasis is inconsistent in the current literature. OBJECTIVE: To assess the bidirectional association between vitiligo and psoriasis. METHODS: A population-based study was performed to compare vitiligo patients (n = 20,851) with age-, sex- and ethnicity-matched control subjects (n = 102,475) regarding the incidence of new-onset and the prevalence of preexisting psoriasis. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were calculated by cox regression and logistic regression, respectively. RESULTS: The incidence rate of new-onset psoriasis was estimated at 7.9 (95% CI 6.4-9.7) and 4.7 (95% CI 4.1-5.3) cases per 10,000 person-years among patients with vitiligo and controls, respectively. Patients with vitiligo experienced an increased risk of psoriasis (fully-adjusted HR 1.71; 95% CI 1.35-2.17; P < 0.001). On the other hand, the odds of vitiligo were only marginally elevated among patients with preexisting psoriasis (fully-adjusted OR 1.19; 95% CI 1.01-1.40; P = 0.051). Compared to other patients with vitiligo, those with vitiligo and comorbid psoriasis were older at the onset of the disease and had a greater prevalence of metabolic and cardiovascular comorbidities. CONCLUSIONS: A diagnosis of vitiligo predisposes individuals to develop subsequent psoriasis. Clinicians managing dermatologic patients ought to be aware of this comorbidity. Further research is required to explicate the pathomechanism underlying this epidemiological observation.

Vitiligo and systemic sclerosis: Are they associated?- Lessons from a population-based study.

BACKGROUND: The epidemiological relationship of vitiligo with systemic sclerosis (SSc) remains to be precisely evaluated. OBJECTIVE: To investigate the bidirectional association between vitiligo and SSc. METHODS: A population-based study was carried out to compare vitiligo patients (n = 20,851) with age-, sex- and ethnicity-matched control subjects (n = 102,475) regarding the incidence of new-onset and the prevalence of preexisting SSc. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were calculated by the Cox regression and logistic regression, respectively. RESULTS: The incidence rate of new-onset SSc was calculated at 2.4 (95% CI, 1.6-3.4) and 0.4 (95% CI, 0.3-0.6) cases per 10,000 person-years among patients with vitiligo and controls, respectively. Patients with vitiligo had an increased risk of SSc (fully adjusted HR, 5.37; 95% CI, 3.03-9.54; p < 0.001). Correspondingly, a history of SSc predicted elevated odds of developing vitiligo (fully adjusted OR, 2.09; 95% CI, 1.23-3.55; p = 0.006). Relative to other patients with vitiligo, those with vitiligo and comorbid SSc were older and had a higher prevalence of ischaemic heart disease, hyperlipidaemia, and hypertension. CONCLUSIONS: A robust bidirectional association exists between vitiligo and SSc. This knowledge is valuable for physicians managing patients with both conditions. Patients with vitiligo and comorbid SSc might be monitored for cardiovascular and metabolic comorbidities.

Hair Shaft Morphology, Elemental Composition, and Nanoparticles in Frontal Fibrosing Alopecia: A Case-control Study.

Frontal fibrosing alopecia is a cicatricial alopecia with rising incidence. Titanium nanoparticles were suggested as a potential environmental trigger, yet this is unproven. This study assessed hair morphology, chemical composition and nanoparticles in 20 patients and 40 healthy controls using scanning electron micro-scopy and energy-dispersive X-ray spectroscopy. Morphological evaluation revealed a significantly higher degree of cuticle weathering in patients compared with controls when there were no differences in hair care routine. There were no differences in the background elemental composition, while particle analysis revealed a significant increase in particles containing titanium, chlorine, silicon, magnesium, and iron in the patient group. Titanium-containing nanoparticles showed the most significant increase, being 8.6 times greater than in controls, without relation to age and disease duration. The results indicate that patients with frontal fibrosing alopecia should be advised to avoid aggressive topical cosmetic and medical hair treatments, and refrain from using cosmetic preparations containing titanium nanoparticles.