The Association Between Vitiligo and Uveitis: A Large Population‐Based Study

BACKGROUND: Vitiligo is a common acquired immune-mediated skin disease, often associated with other systemic inflammatory conditions. However, a clear association between vitiligo and uveitis, a vision-threatening inflammatory eye condition, has not been confirmed. This study sought to investigate the association between vitiligo and uveitis. METHODS: A large population-based cross-sectional study was conducted. The database of a large health maintenance organization was screened for patients with a dermatologist-documented diagnosis of vitiligo as of January 2024. Cases secondary to Behçet disease or Vogt-Koyanagi-Harada syndrome were excluded. Eligible patients were matched 5:1 with healthy controls, and the groups were compared for prevalence of uveitis, as documented clinically by an ophthalmologist in the same database. Outcome measures were adjusted for age, sex, and referral clinic. Multivariate logistic regression models were applied to study the independent relationship between variables. RESULTS: The study population included 24,398 consecutive patients with vitiligo and 114,609 control subjects. The estimated prevalence of uveitis was 0.53% and 0.39%, respectively. The odds of having uveitis was 35% higher in the patient than the control group (odds ratio [OR] 1.35; 95% confidence interval [CI] 1.11-1.64; p = 0.003). On multivariate analysis, there was an independent association between vitiligo and uveitis (OR 1.30; 95% CI 1.03-1.64, p = 0.024) regardless of a history of uveitis-associated conditions (inflammatory bowel disease, sarcoidosis). CONCLUSION: Vitiligo is associated with an increased prevalence of uveitis. Dermatologists should be alert to this potential comorbidity because a coordinated multidisciplinary approach is essential to prevent long-term ocular sequelae. Large prospective studies are needed to corroborate these findings.