Medically reviewed by Dr. John Harris, dermatologist and Director of the UMass Vitiligo Clinic and Research Center
Did you know that vitiligo is an autoimmune disease? An autoimmune disease occurs when an individual’s immune system becomes hyperactive. In vitiligo, this hyperactivity causes the body to attack its own skin cells, called melanocytes, resulting in the loss of pigment.
Why does this matter?
This type of hyperactivity in the immune system can extend to other organs too. This phenomenon, the presence of more than one autoimmune disease, is called comorbidity and is not uncommon. According to a 2016 study in the Journal of the American Academy of Dermatology, a review of 1,100 vitiligo patient charts revealed that 19.8% of the patients had at least one other autoimmune disease and 2.8% had more than one.
If you live with vitiligo, it’s important to know that you have the potential to also be living with other autoimmune diseases. What are some of these diseases and the signs and symptoms to look out for? Today, we’ll cover three of the common comorbidities, but you can find a full list of autoimmune diseases here.
The thyroid is a small, H-shaped organ found at the front of the neck that produces hormones to regulate metabolism and maintain optimal levels of brain, muscle, and heart functions. Autoimmune diseases of the thyroid come in two different types: hyperthyroidism and hypothyroidism.
Hyperthyroidism, also known as Graves disease, occurs when the immune system stimulates the thyroid to produce too much thyroid hormone. This will cause an increase in metabolic rate and increased heart and muscle activity. Symptoms to look out for include weight loss, increased heart rate, anxiety, bulging eyes, heat intolerance, irregular menses, and muscle tremors.
Hypothyroidism, also known as Hashimoto’s disease, is when the immune system attacks hormone-synthesizing molecules and too little thyroid hormone is produced. This will cause a decrease in metabolic rate and decreased heart and muscle activity. Hypothyroidism can result in weight gain, decreased heart rate, depression, cold insensitivity, and dry skin/hair. It has been found that vitiligo patients have a 15-20% greater chance of developing hypothyroidism.
Overall, autoimmune thyroid diseases are by far the most common ones in vitiligo patients. A 2016 study in the Journal of the American Academy of Dermatology found that the most common comorbidity was thyroid disease, with a prevalence of 12.3%.
Pernicious anemia is the inability to produce enough red blood cells because of a Vitamin B12 deficiency. When this occurs, the immune system destroys stomach proteins that help with Vitamin B12 absorption. Specific signs to look out for include fatigue, lightheadedness, muscle weakness, loss of reflexes, loss of balance, and unsteadiness.
Rheumatoid arthritis is joint inflammation that occurs due to the immune system destroying the synovium, which is the lining of joint spaces. Characteristically, this disorder affects small joints first, like the fingers, and then progresses to larger joints, like the knee. Rheumatoid arthritis can cause joint pain/tenderness, morning stiffness that improves with use, multiple joints involved bilaterally, fatigue, and weakness.
How to screen for autoimmune diseases
If you or someone you know is living with vitiligo and is concerned about or experiencing any of the aforementioned symptoms, it is best to talk to with your doctor. Discuss any concerns you may have and create a plan to screen for these additional autoimmune diseases.
Disclaimer: This list is provided for informational purposes only. Please consult your dermatologist to determine the best treatment options for you.
Rachita Pandya is a medical student with an interest in clinical dermatology. She hopes to empower and educate others on how to embrace their skin. In her free time, she likes to cook, travel, and spend time with friends and family.