Question 14. What are the individual factors ...?

Question 14. What are the individual factors associated with propensity to vitiligo?

Key points

  • Heridity: 20% of people with vitiligo report about a first degree relative as the one suffering from vitiligo.
  • Human Leukocyte Antigen (HLA) haplotype may contribute to vitiligo susceptibility.
  • A number of pathological conditions have been associated with vitiligo: their presence might be considered a propensity to disease development.
  • The disease onset is frequently associated with stressful life events.
  • Physical trauma of the skin may induce vitiligo (Koebner phenomenon).

It is well-known that heredity is an issue in vitiligo propensity. In fact, around 20% of people with vitiligo report about a first degree relative as the one suffering from the same disorder. Children of a vitiligo affected subject have a 1.7-fold increased risk of developing vitiligo compared with other family members. HLA haplotypes may contribute to generalized vitiligo susceptibility, i.e. HLAs -A2, -DR4, - DR7 and -DQB1 0303.

NALP-1 gene (NACHT leucine rich- repeat protein 1) is a major susceptibility gene that is epidemiologically linked to generalized vitiligo and other autoimmune diseases (i.e. thyroid disease, pernicious anemia, and lupus erythematosus). Patients already affected by the following diseases are more prone to develop vitiligo (and vice versa):

- Alopecia areata Pernicious anemia IgA selective defect
- Thyroid autoimmune disease
- Addison’s disease
- Congenital melanocytic neviMELAS syndrome (mitochondrial encephalomyopathy, lactic acidosis, and stroke episodes syndrome).

Stressful life events, probably interfering with the psycho-neuro-endocrine-immune system, and physical traumas of skin, including solar burns, may easily promote vitiligo onset in predisposed subjects.

Author: Prof. Torello Lotti, MD

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