Pigmentation Traits, Sun Exposure, and Risk of Incident Vitiligo in Women

Abstract

Vitiligo is the most common cutaneous depigmentation disorder worldwide, yet little is known about specific risk factors for disease development. Using data from the Nurses' Health Study, a prospective cohort study of 51,337 white women, we examined the associations between (i) pigmentary traits and (ii) reactions to sun exposure and risk of incident vitiligo. Nurses' Health Study participants responded to a question about clinician-diagnosed vitiligo and year of diagnosis (2001 or before, 2002-2005, 2006-2009, 2010-2011, or 2012+). We used Cox proportional hazards regression models to estimate the multivariate-adjusted hazard ratios and 95% confidence intervals of incident vitiligo associated with exposures variables, adjusting for potential confounders. We documented 271 cases of incident vitiligo over 835,594 person-years. Vitiligo risk was higher in women who had at least one mole larger than 3 mm in diameter on their left arms (hazard ratio = 1.37, 95% confidence interval = 1.02-1.83). Additionally, vitiligo risk was higher among women with better tanning ability (hazard ratio = 2.59, 95% confidence interval = 1.21-5.54) and in women who experienced at least one blistering sunburn (hazard ratio = 2.17, 95% confidence interval = 1.15-4.10). In this study, upper extremity moles, a higher ability to achieve a tan, and history of a blistering sunburn were associated with a higher risk of developing vitiligo in a population of white women.

Photoprotection according to skin phototype and dermatoses: practical recommendations from an expert panel

“…Vitiligo patients have decreased risk of developing skin cancer, especially melanoma 86,87 . Although sunburn is a provoking factor for vitiligo, 88,89 repigmentation of vitiligo lesions is almost impossible without UV exposure (natural or using phototherapy booths, lamps or lasers) 90,91 . Vitiligo patients should be advised to regularly expose their lesional skin to the sun until vitiligo lesions become pink, after which a high‐SPF broad‐spectrum sunscreen is advised to prevent sunburn 90,91 …”

Nicastrin Deficiency Induces Tyrosinase-Dependent Depigmentation and Skin Inflammation

“…In addition, the later PTU treatment suggested that reducing the accumulated damages within a tolerable range could prevent melanophore cell death. To test this, different doses of PTU were used to suppress melanin production; the results showed that the lower the melanin production rate, the fewer melanophores die in nicastrin mutants (Supplementary Figure S11), which intriguingly echoed the association of blue and green eyes and tanning ability with vitiligo prevalence in previous clinical observations (Dunlap et al, 2017;Jin et al, 2010;Jin et al, 2012).…”

“…Second, melanin synthesis is associated with vitiligo (Jin et al, 2010;Jin et al, 2012). Third, vitiligo correlates with tanning ability (Dunlap et al, 2017). Fourth, melanocyte toxic factors are Tyrosinase substrates (van den Boorn et al, 2011;Tokura et al, 2015).…”

Development of evidence‐based consensus on critical issues in the management of patients with vitiligo: A modified Delphi study

“…Mechanical trauma, including repetitive rubbing or friction, causes chronic loss of epidermal melanocytes, triggering vitiligo 79,80 . In terms of sun exposure, extensive tanning and sunburn‐induced blisters were associated with a higher risk of vitiligo in a prospective cohort of Caucasian females 81 . Also, the use of permanent hair dyes may trigger vitiligo in susceptible individuals 77,82 …”