International Journal of Research in Dermatology

Anupama YG et al. Int J Res Dermatol. 2018 Nov;4(4):556-558

http://www.ijord.com

Original Research Article

DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20184460

Prevalence of vitiligo at the tertiary health care centre, Mc Gann’s teaching district hospital Shivamogga

Y. G. Anupama1, Geetha Bhaktha2, B. Manjula2, H. J. Dadapeer1*, K. S. Govinda Swamy3, R. S. Jyothi3, L. H. Halesh4

1Department of Dermatology and STD, 2Multidisciplinary Research Unit, 3Department of Biochemistry, 4Department of Microbiology, Shimoga Institute of Medical Sciences, Shivamogga, Karnataka, India

Received: 25 June 2018

Accepted: 02 August 2018

*Correspondence:

Dr. H. J. Dadapeer,

E-mail: mrushivamoga@gmail.com

Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: Vitiligo is a common depigmentation disorder involving persons of all ages and both genders uniformly throughout the races. The highest incidence of vitiligo has been recorded in Indians from the Indian subcontinent, along with Mexicans and Japanese.

Methods: Patients visiting Dermatology OPD were recruited for the study at the tertiary health care centre, Mc Gann’s teaching district hospital Shivamogga. Data regarding health-related status and other factors were collected between January to December 2017.

Results: Among the potential candidates, 8.6% of our study population was with the positive family history of vitiligo and 50.9% were females and 49.1% were males. Patients with age from 27-36 years were found to be affected mostly. The most common site of onset was the lower limbs (30%) followed by head and neck (25.4%) with the commonest pattern to be of acro-facial type.

Conclusions: This study suggests that local epidemiological behavior of vitiligo was not the same across different regions. Variations did exist and may possibly be due to certain clinico-epidemiological parameters of Shimoga viz., prevalence of associated diseases and its extent of involvement.

Keywords: Vitiligo, Acro-facial, Clinical epidemiology, Shivamoga

INTRODUCTION

Vitiligo is an acquired pigmentary disorder of the skin with a worldwide incidence of 0.1 to 2%.1,2 The characteristic features are milky-white macules or patches owing to the selective impairment of melanocytes, which occurs over various sites on skin and mucous membrane. The pathogenesis of vitiligo is due to any one or combined effect of metabolic abnormalities, oxidative stress, generation of inflammatory mediators, cell detachment and autoimmune responses but the exact cause is still controversial. Epidemiological studies on vitiligo have been seldom reported from South India. Hence the aim is to study the prevalence of vitiligo patients visiting dermatology department at the tertiary health care center, Mc Gann teaching District hospital Shivamoga.

METHODS

A prospective study was conducted in Dermatology outpatient and inpatient department, District Mc Gann Teaching Hospital, SIMS, Shivamogga during January to December 2017. All patients with vitiligo were enrolled in the study. Patients were diagnosed by clinical examination. Results were tabulated and were analyzed.

Statistical analysis

The statistical analysis was carried out with Statistical Package for Social Science for Windows Ver.11.0.

RESULTS

Patients visiting Dermatology OPD were recruited for the study. Among them 116 patients with vitiligo were included for the study. Out of which 50.9% were females and 49.1% were males (Table 1). The male to female ratio was 1:1.04.

Table 1: Prevalence of vitiligo with respect to gender.
Table reproduced from source PDF page 2

The majority of patients belongs to the age group of 27 to 36 years (22.4%) followed by 17-26 (21.6%), ≥16 (16.4%), 37-46 (15.5%), 47-56 (10.3%), 57-66 (9.5%) and ≤67 years (3.31%) (Table 2).

Table 2: Prevalence of vitiligo with respect to age.
Table reproduced from source PDF page 2

About 8.6% of patients had the positive family history (Table 3).

Table 3: Prevalence of family history of vitiligo with respect to gender.
Table reproduced from source PDF page 2

In non-segmental (41.6%) type of vitiligo, acro-facial (18.7%) was the most common type, followed by mixed (7.7%), mucosal (7.6%), universal (4.2%) and vulgaris (3.4%). Segmental vitiligo was found in 20.3% of patients. In unclassified vitiligo (38.1%), the focal and mucosal type was found in 33% and 5.1% respectively (Table 4).

Table 4: Prevalence of vitiligo types with respect to gender.
Table reproduced from source PDF page 2

Lesions were mostly seen on lower limbs (30%) followed by head and neck (25.4%), upper limbs (24%), trunk (10.6%) and oral and genital mucosa (10%) (Table 5).

Table 5: Prevalence of site of onset in vitiligo with respect to gender.
Table reproduced from source PDF page 2

DISCUSSION

The prevalence of vitiligo is considered to be highest in India, varying from 0.46 and 8.8%.3 The female to male ratio in our study was 1.04:1. Shajil et al showed that males and females were affected with almost equal frequency though Khaitan et al showed males were more commonly affected than females whereas Shah et al showed slightly higher prevalence in female population.4-6 This may be due to different ethnic backgrounds of population residing in different geographic region with different environmental condition may contribute to the wide variation in prevalence of vitiligo in India.

In our study, mean age of onset was 4 years, consistent with the most reports from India and other countries. 6 A considerable number of patients with vitiligo were identified before 20 years of age followed by half of it before the age of 10 years which is agreeable with our study (data not shown).7,8 This implies that the disease starts at a younger age.

Family history plays an important role in manifestation of vitiligo.9 In our study, 8.63% of study population had positive family history of vitiligo, out of which females (6.03%) were more compared to males (2.6%). Familial occurrence has been reported to vary from 5 to 30% in different studies.10,11

Lower limbs was the most common involved site which is supported with other studies.12,13 Other sites involved were head and neck (25.4%) followed by upper limbs (24%), trunk (10.6%), and oral and genital mucosa (10%).

Our study infers acro-facial type of vitiligo was the commonest pattern, followed by other patterns. Conversely in other studies, vitiligo vulgaris was the most common type followed by acrofacial, segmental, universal, and mucosal vitiligo.11 This variation may be due to multifactorial causes (autoimmune disorder, oxidative stress imbalance, critical sun burn, exposure to some toxic chemicals, heredity or viral infection).

CONCLUSION

The data suggests that local epidemiological behavior of vitiligo need not be the same across different regions. Variations do exist and may be due to certain clinico-epidemiological parameters of Shimoga viz., prevalence of associated diseases and its extent of involvement.

ACKNOWLEDGEMENTS

The authors acknowledge the Department of Health Research (DHR), New Delhi, India, for support for this study at Multidisciplinary Research Unit (MRU) - Shimoga Institute of Medical Sciences, Shivamogga. The authors thank all the participants contributed to the study.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the institutional ethics committee of Shivamoga institute of medical college, Shimoga

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