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Recurrence and relapse in nonsegmental vitiligo: phenotypic and autoimmune predictors from a large retrospective

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Non-segmental vitiligo often recurs after treatment. Acral involvement, thyroid disease, and other autoimmune conditions predict recurrence, with combined acral and thyroid issues posing the highest risk.

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Area of Science:

  • Dermatology
  • Autoimmunity
  • Epidemiology

Background:

  • Non-segmental vitiligo frequently recurs post-treatment, necessitating identification of high-risk patients for effective long-term management.
  • Understanding recurrence predictors is crucial for personalized maintenance strategies.

Purpose of the Study:

  • Identify phenotypic and autoimmune predictors of recurrence in non-segmental vitiligo.
  • Establish a clinical risk-stratification framework for recurrence.

Main Methods:

  • Retrospective cohort study (2015-2024) of 809 patients with stable non-segmental vitiligo.
  • Multivariable Cox proportional hazards models analyzed predictors of recurrence/relapse.
  • Joint-exposure model assessed combined acral involvement and thyroid disease.

Main Results:

  • 32.88% of patients experienced recurrence/relapse.
  • Independent predictors: acral involvement (aHR 1.56), thyroid disease (aHR 1.42), and other autoimmune comorbidities (aHR 1.73).
  • Combined acral and thyroid disease significantly increased recurrence hazard (aHR 2.44).

Conclusions:

  • Acral involvement, thyroid disease, and autoimmune comorbidities predict non-segmental vitiligo recurrence.
  • Combined acral and thyroid disease identifies a high-risk subgroup.
  • Risk stratification aids in personalized maintenance planning and monitoring.