Cigarette smoking is an independent risk factor for developing vitiligo on the hands

Abstract

BackgroundVitiligo presents with varying clinical features based on the type and location. Treatment tends to be more effective on the face, neck, trunk, and mid‐extremities, while the lips and distal extremities may be more resistant. Vitiligo in frequently exposed areas such as the face, arms, legs, and hands is typically associated with a lower Dermatology Life Quality Index.ObjectivesWe aimed to identify the characteristics and potential causes of vitiligo in challenging‐to‐treat regions, with particular focus on the hands.MethodsWe analyzed the clinical data of 337 patients with generalized vitiligo who visited our hospital between 2016 and 2022. For this study, we focused on patients with non‐segmental vitiligo (NSV) specifically on their hands. Of the 337 patients, 248 had NSV and 89 had segmental vitiligo; 119 (47%) of those with NSV had vitiligo on their hands. Logistic regression models were applied to identify factors the factors linked to hand vitiligo, such as age, sex, duration of the condition, and smoking and alcohol history.Results and ConclusionsWe developed a model to predict the risk of hand vitiligo using several factors. Among the factors analyzed, only smoking history was significantly associated with an increased risk (odds ratio: 3.13). In addition, we used clinical photography to evaluate color‐graded frequency heat maps comprising 528 pixels. Vitiligo in nonsmokers widely distributed over the hand, predominantly the fingertips and joints, whereas vitiligo in smokers tended to be distributed mostly at the fingertips.

Phototherapy for pigmentary disorders

“…Narrowband ultraviolet B (NB-UVB) is effective for repigmentation on the face and trunk but presents a therapeutic gap for acral areas, the most difficult-to-treat areas. Morita and colleagues 11 analyze the risk factors for hand vitiligo, highlighting cigarette smoking as a significant risk factor, particularly for vitiligo on the fingertips. Smoking history correlates significantly with hand vitiligo, with more intense manifestations at the fingertips.…”