BEHÇET'S SYNDROME IS NOT ASSOCIATED WITH VITILIGO

Background: Behçet's syndrome (BS) has many features different from autoimmune diseases (1), including a lack of association with Sjögren's syndrome (2). Vitiligo is frequently associated with various autoimmune disorders such as autoimmune thyroiditis, pernicious anemia and Addison's disease. Our informal observation was that vitiligo was also very uncommon among BS patients. With this controlled and masked study we formally surveyed the presence of vitiligo among BS patients and suitable controls.Methods: Patients with Behçet's syndrome, Graves' disease and Hashimoto's thyroiditis followed in the Rheumatology and Endocrinology departments of a university hospital and healthy controls were examined. Subjects with hypopigmented lesions were reexamined by a dermatologist in a masked protocol. Woods lamp was used to confirm the diagnosis of vitiligo in suspected lesions.Results: 253 consecutive BS patients (158 males, 95 females, mean age 36.7 ± 9.9 years), 34 Graves' disease patients (10 males, 24 females, mean age 38.8 ± 11 years), 32 Hashimoto's thyroiditis patients (2 males, 30 females, mean age 46.7 ± 10.8 years), and 439 healthy controls (166 males, 272 females, mean age 42.4 ± 17.7 years) were surveyed. Behçet's syndrome patients were significantly younger than Hashimoto's thyroiditis patients and healthy controls (p=0.002 and p<0.0001 respectively). None of the BS patients had vitiligo while 6/34 (17.6%) of Graves' disease patients (p<0.0001), 6/32 (18.7%) of Hashimoto's thyroiditis patients (p<0.0001) and 4/439 (0.9%) of healthy controls (p=0.161) had vitiligo. All subjects with vitiligo, except for one patient with associated Graves' disease, were females. There was no statistically significant difference between the ages of subjects with and without vitiligo in each group. Data were further analysed using Mantel-Haenszel test and binary logistic regression to detect a possible effect of sex and age on the difference of vitiligo frequency among the groups. The findings remained robust.Conclusion: In contrast to two autoimmune diseases, Hashimoto's thyroiditis and Graves' disease, the frequency of vitiligo was not increased among patients with BS. This constitutes further evidence that traditional autoimmune mechanisms might not be operative in BS.References: 1. Yazici H. Int Rev Immunol. 1997;14:1-102. Gunaydin I. et al. J Rheumatol. 1994;21:1662-4Citation: Ann Rheum Dis, volume 65, supplement II, year 2006, page 370Session: Vasculitis