rifampin and Vitiligo

Topics: Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Humans; Immunocompromised Host; Isoniazid; Male; Middle Aged; Penile Diseases; Pyrazinamide; Rifampin; Skin Ulcer; Tuberculosis, Male Genital; Vitiligo

Leprosy and vitiligo are common affections in the West Indies. Vitiligo frequently occurs in lepromatous patients, an observation rarely reported in the literature.. We studied the prevalence of vitiligo in patients affected by leprosy by performing a retrospective study between 1978 and 1999 in the French West Indies (Martinique).. Eleven patients presented with vitiligo among 101 with lepromatous (multibacillary) leprosy. None presented with vitiligo among the 364 with the tuberculoid (paucibacillary) form. The mean age of the vitiligo patients was 55. 4 years at vitiligo onset. The sex ratio was 0.8. Vitiligo occurred 19 years after the diagnosis of leprosy, with a range from 3 to 42 years. The prevalence of vitiligo in lepromatous patients was 10.9%, compared to 0% in tuberculoid patients. Such an increase in prevalence compared with that in the general population (0.34%) was shown to be highly significant (P< 0.0001).. Our data confirmed that the association of vitiligo and leprosy was not fortuitous. The physiopathology leading to this high rate of vitiligo in lepromatous leprosy is unclear, despite the fact that autoimmunity plays a major role in both diseases.

Topics: Adult; Aged; Aged, 80 and over; Clofazimine; Dapsone; Female; Humans; Leprostatic Agents; Leprosy, Lepromatous; Male; Martinique; Middle Aged; Prevalence; Retrospective Studies; Rifampin; Thalidomide; Vitiligo

A middle-aged male with lepromatous leprosy developed bouts of skin lesions of depigmented macules and patches of vitiligo, just following attacks of type II lepra reaction each time. In view of the present concept of autoimmunity playing a role in the pathogenesis of vitiligo as well as lepra reaction, their association in our patient appears to be more than fortuious. The depigmented macules persisted even after regression of skin lesions of leprosy following chemotherapy. The vitiligo macules responded partially to topical and systemic psoralen therapy.

Topics: Autoimmune Diseases; Clofazimine; Dapsone; Drug Therapy, Combination; Follow-Up Studies; Humans; Leprosy, Lepromatous; Male; Middle Aged; Rifampin; Vitiligo