Frequency of Benign and Malignant Tumors in Localized Vitiligo in Comparison to Generalized and Universal Vitiligo
- 1 Department of Dermatology, College of Medicine, University of Baghdad, Baghdad, Iraqi
- 2 Department of Dermatology, College of Medicine, University of Baghdad, Baghdad, Iraqi
- 3 Department of Dermatology, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq
- 4 Iraqi and Arab Board for Dermatology and Venereology, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq
Abstract
Background: Autoimmune diseases like pemphigus and systemic lupus erythematosus are protective against skin malignancies like basal cell carcinoma and squamous cell carcinoma. Objective: As vitiligo is an autoimmune diseases, the aim of the present work is to record the frequency of all benign and malignant skin tumors among patients with different severity of vitiligo and to be compared with the skin tumors in healthy control. Patients and Methods: This is a case series, descriptive study done in the Department of Dermatology—Baghdad Teaching Hospital, Baghdad, Iraq, during the period from May 2014-May 2015. History was taken from each patient with vitiligo regarding age, gender, duration, personal and family history of vitiligo and other autoimmune diseases such as diabetes mellitus, thyroid dysfunction, and alopecia areata. Patients were assessed for past and present history of photodermatosis and any skin cancers. Healthy control was considered. Results: Three hundred and fifty patients with vitiligo were included in this study: 50 patients with universal vitiligo, 100 patients with generalized vitiligo, and 200 patients with localized vitiligo as well as 500 subjects as a healthy control. The ages of all studied subjects ranged between 31 and 77 years. Twenty four(48%) patients with universal vitiligo were males and 26 (52%) were females; 49(49%) patients with generalized vitiligo were males and 51(51%) were females; 101(50.5%) patients with localized vitiligo were males and 99(49.5%) were females and 235(47%) of control were males and 265(53%) were females. All skin tumors were seen to be high in healthy subjects and lower or absent in patients with vitiligo. Also patients with mild vitiligo had a higher frequency of skin tumors including benign and malignant than patients with severe vitiligo especially in patients with universal vitiligo. In addition, no photosensitivity or actinic reticuloid was detected in patients with vitiligo. Conclusions: Vitiligo especially generalized and universal type as an autoimmune disease had a protective action against photodamage, photosensitivity and skin tumors whether benign or malignant.
- Alikhan, A., Felsten, L.M., Daly, M. and Petronic-Rosic, V. (2011) Vitiligo: A Comprehensive Overview Part I. Introduction, Epidemiology, Quality of Life, Diagnosis, Differential Diagnosis, Associations, Histopathology, Etiology, and Work-Up. Journal of the American Academy of Dermatology, 65, 473-491. http://dx.doi.org/10.1016/j.jaad.2010.11.061
- Jin, Y., Riccardi, S.L., Gowan, K., Fain, P.R. and Spritz, R.A. (2010) Fine-Mapping of Vitiligo Susceptibility Loci on Chromosomes 7 and 9 and Interactions with NLRP1 (NALP1). Journal of Investigative Dermatology, 130, 774-783. http://dx.doi.org/10.1038/jid.2009.273
- Truhan, A.P. (1991) Sun Protection in Childhood. Clinical Pediatrics, 30, 412-421. http://dx.doi.org/10.1177/000992289103000702
- Patton, L.L. and Valdez, I.H. (1991) Xerodermapigmentosum: Review and Report of a Case. Oral Surgery, Oral Medicine, Oral Pathology, 71, 297-300. http://dx.doi.org/10.1016/0030-4220(91)90303-T
- Liddington, M., Richardson, A.J., Higgins, R.M., Endre, Z.H., Venning, V.A., Murie, J.A. and Morris, P.J. (1989) Skin Cancer in Renal Transplant Recipients. British Journal of Surgery, 76, 1002-1005. http://dx.doi.org/10.1002/bjs.1800761005
- Sharquie, K.S., Noaimi, A.A. and Al-Jobori, A.A. (2013) Skin Tumors and Skin Infections in Kidney Transplant Recipients vs. Patients with Pemphigus Vulgaris. International Journal of Dermatology, 2013, 1-6.
- Sharquie, K.E., Noaimi, A.A., Bandar, A.R. and Mohsin, S.Y. (2014) Vitiligo: Skin Malignancies and Tumor Suppressive Marker P53. Pigmentary Disorders, 1, 1.
- van den Wijngaard, R.M., Aten, J., Scheepmaker, A., Le Poole, I.C. and Tigges, A.J. (2000) Expression and Modulation of Apoptosis Regulatory Molecules in Human Melanocytes: Significance in Vitiligo. British Journal of Dermatology, 143, 573-581. http://dx.doi.org/10.1111/j.1365-2133.2000.03712.x
- Bolshakov, S., Walker, C.M. and Strom, S.S. (2003) P53 Mutations in Human Aggressive and Non-Aggressive Basal and Squamous Cell Carcinomas. Clinical Cancer Research, 9, 228.
- Kim, M. and Park, H.J.S. (2002) Mutations of the P53 and PTCH Gene in Basal Cell Carcinomas: UV Mutation Signature and Strand Bias. Journal of Dermatological Science, 29, 1-9. http://dx.doi.org/10.1016/S0923-1811(01)00170-0
- Wang, S.Q., Setlow, R. and Berwick, M. (2001) Ultraviolet A and Melanoma: A Review. Journal of the American Academy of Dermatology, 44, 837-847. http://dx.doi.org/10.1067/mjd.2001.114594