Vitiligo: Clinical and Laboratory Characteristics in 573 Saudi Patients

Abstract

Background: Vitiligo is a common disease. Limited studies in Saudi Arabia have explored the detailed clinical characteristics of vitiligo, as outlined in recent consensus reports by vitiligo experts.

Objective: To determine vitiligo prevalence and detailed clinical characteristics in a Saudi cohort.

Methods: Cross-sectional study over six years. All cases were electronically identified and manually verified. Prevalence and sex were determined based on all vitiligo cases. Detailed analysis was done only for patients seen in a specialized vitiligo clinic with standardized documentation.

Results: There were 1555 vitiligo cases (prevalence 0.235% [95% confidence interval 0.224-0.247], 938 [60.32%] were female). Detailed analysis for other variables was done in 573 patients. Onset before age 20 years was found in 49%. Family history of vitiligo was reported in 42.15%. Triggering factors were present in 32% with stress being the most common (24%). Proportion of clinical characteristics was as follows: nonsegmental vitiligo (88%), signs of activity (49%), lesional pruritus (25%), halo nevi (4%), leukotrichia (19%). Some patients had isolated facial involvement and others had leukotrichia on the eyelids (not eyelashes). Atopy and hypothyroidism were the most prevalent systemic diseases, while alopecia areata, atopic dermatitis, and psoriasis were the top skin conditions. Antithyroid antibodies were high in approximately a third of patients and the majority of patients had low vitamin D. Elevated erythrocyte sedimentation rate (ESR) was observed more in patients with clinical signs of activity (70% vs 54%, p-value 0.0007).

Conclusion: Prevalence of vitiligo was found to be similar to worldwide figures, with a higher proportion having affected family members. Stress as a trigger, lesional pruritus, signs of activity, thyroid disease, and low vitamin D were all common and should be routinely checked. Novel findings include isolated facial involvement, eyelid leukotrichia, and high ESR in active vitiligo.

Keywords: Arab; Saudi; depigmentation; dermatology; melanocytes; middle east; vitiligo.

Figure 1

Body sites affected by vitiligo (n = 571).

Figure 2

Body sites affected by leukotrichia (n = 102).