Khalaf Kridin1,2,3, Keren Lyakhovitsky4, Orly Weinstein5,6, Arnon D Cohen5,6, Erez Onn7, Anna Lyakhovitsky8,9, Ralf Ludwig10. 1. Unit of Dermatology and Skin Research Laboratory, Baruch Padeh Poria Medical Center, M.P. The lower Galilee, 15208, Poriya, Israel. dr_kridin@hotmail.com. 2. Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel. dr_kridin@hotmail.com. 3. Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany. dr_kridin@hotmail.com. 4. Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel. 5. Clalit Health Services, Tel-Aviv, Israel. 6. Faculty of Health Sciences, Ben-Gurion University of the Negev, Ben-Gurion Ave, Beer Sheva, Israel. 7. Baruch Padeh Medical Center, Poriya, Israel. 8. Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel. 9. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 10. Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.
Abstract
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.
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.