Objective. Behcets syndrome (BS) has many features that are different front autoimmune diseases, including a lack of association with Sjogren's syndrome. Vitiligo is frequently associated with various autoimmune disorders such as autoimmune thyroiditis, pernicious anemia and Addisons disease. Our informal observation was that vitiligo is also uncommon among BS patients. With this controlled and masked study we formally surveyed the presence of vitiligo among BS patients and suitable controls.
OBJECTIVE: Behçet's syndrome (BS) has many features that are different from autoimmune diseases, including a lack of association with Sjögren's syndrome. Vitiligo is frequently associated with various autoimmune disorders such as autoimmune thyroiditis, pernicious anemia and Addison's disease. Our informal observation was that vitiligo is also 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 being followed in the rheumatology and endocrinology departments of a university hospital and healthy controls were examined. Subjects with hypopigmented lesions were re-examined by a dermatologist in a masked protocol. Wood's lamp was used to confirm the diagnosis of vitiligo in suspected lesions.
RESULTS: 253 consecutive BS patients, 34 Graves' disease patients, 32 Hashimoto's thyroiditis patients, and 439 healthy controls were surveyed. None of the BS patients had vitiligo, while 6/34 (17.6%) of Graves' disease patients, 6/32 (18.7%) of Hashimoto's thyroiditis patients, and 4/439 (0.9%) of healthy controls had vitiligo. All the subjects with vitiligo, except for one patient with associated Graves' disease, were women.
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 may not be operative in BS.
