Vitiligo—Thyroid Disease Association: When, in Whom, and Why Should It Be Suspected? A Systematic Review

Abstract

In most dermatological pathologies, the phenomena observed on the skin are a reflection of internal disorders. In patients with associated acral involvement on the dorsal sides of the hands, this “vitiligo phenotype” may lead to the investigation of certain associated pathologies that sometimes have no obvious clinical impact. To assess the link between skin depigmentation and autoimmune pathologies, we conducted a systematic review involving article selection from the PubMed database. Patients with coexisting thyroid pathologies were found to have a predisposition for developing acral vitiligo and depigmentation of the wrists, and autoimmune thyroid pathologies appeared to be the only coexisting autoimmune or inflammatory diseases in vitiligo patients to show a pattern of distribution. The association of concomitant thyroid dysfunction with depigmentation of the hands was found to be so strong that the absence of depigmented macules on the hands may exclude the coexistence of an autoimmune thyroid pathology. Although the frequency of acral involvement in patients with vitiligo and autoimmune pathologies is higher, the mechanism by which thyroid dysfunction influences this distribution pattern remains incompletely elucidated and requires future studies.

Identification of Shared Biomarkers and Immune Infiltration Signatures between Vitiligo and Hashimoto’s Thyroiditis

“… 10 Also, patients with vitiligo and autoimmune thyroiditis have a predisposition to developing acral lesions and discolored patches of wrists. 11 In the subgroup analysis, vitiligo had a stronger association with HT in males than females, and they had the strongest association in children and adolescents (aged under 20 years). 12 Genetic factors 13 and autoimmune etiology are primarily involved in the synchronicity of the two diseases, but the exact immunological mechanism of the comorbidity remains unclear.…”

Understanding Vitiligo: Causes, Diagnosis, Promising Advances in Treatment and Management and the Impact on Mental Health

“…Finally, Zinc hinders the destruction of melanocytes. While it yields slight benefits when used in conjunction with topical steroids, it is important to consult with a healthcare professional before starting any alternative treatments 26 .…”

An Overview of Clinical Manifestations of Dermatological Disorders in Intensive Care Units: What Should Intensivists Be Aware of?

“…It can affect any part of the skin, but it is most noticeable on the face, hands, and wrists, as well as around body orifices. Although specific causes are unknown, studies indicate a link to immune system changes [ 95 ]. The condition is frequently associated with autoimmune thyroid disease [ 96 ], pernicious anemia [ 97 ], diabetes mellitus [ 98 ], systemic lupus erythematosus [ 99 ], celiac disease [ 100 ], and Addison’s disease or after using biological agents such as adalimumab, infliximab, ustekinumab, secukinumab, and ixekizumab [ 101 ].…”