Vitiligo in an Italian outpatient center: a clinical and serologic study of 204 patients in Tuscany.

Background: Vitiligo is a depigmentation disorder resulting from destruction of cutaneous melanocytes that affects 0.1-2% of the world's population, irrespective of sex and race.

Objective: To investigate the clinical and immunopathologic characteristics of a series of Italian vitiligo patients.

Methods: We examined clinical and immunopathologic data of 204 patients affected by vitiligo at a university-based dermatology outpatient hospital (second clinic) between January 1998 and March 2008. In particular, the clinical-epidemiologic characteristics of our patients, serologic parameters suggestive of immune/autoimmune activity (autoantibodies, immune complexes, complement, immunoglobulins), and the association between vitiligo and HLAs were investigated.

Results: Upon comparison of our results with control and literature values, the following aspects appeared to be in complete agreement: the frequency of clinical subtypes of vitiligo, an earlier onset of segmental compared with non-segmental vitiligo, the association of familial vitiligo with other autoimmune diseases, the greater association of non-segmental vitiligo than segmental vitiligo with autoimmune diseases, and some features of pediatric vitiligo. Other data were partially consistent with the literature, such as the association between vitiligo and autoimmune diseases/autoantibody activities, and the association between vitiligo and HLAs. Finally, a portion of our data did not concur with the literature, including the sex distribution and mean age of onset, the lack of association between halo nevi and autoimmune diseases, and some aspects of pediatric vitiligo.

Conclusions: This study provides novel information regarding clinical features and serologic parameters in different subgroups of vitiligo, namely a significant association between active vitiligo and autoantibody activities, and significant clinical differences (i.e. activity of disease, age of onset, and coexistence of other autoimmune diseases) between vitiligo associated with autoantibodies and vitiligo negative for autoantibodies.