Halo Nevi Association In Nonsegmental Vitiligo Affects Age At Onset And Depigmentation Pattern

Objective: To compare factors associated with halo nevi with nonsegmental vitiligo (NSV) vs NSV alone.Design: Prospective observational study in 553 patients with a confirmed diagnosis of NSV attending a vitiligo clinic between January 1, 2006, and July 1, 2010.Setting: Vitiligo Clinic at the Department of Dermatology, University Hospital Center of Bordeaux, Bordeaux, France.Patients: The Vitiligo European Task Force questionnaire was informed for each patient attending the clinic with a confirmed diagnosis of NSV after the exclusion of other forms of vitiligo (focal, mucosal, and not classifiable). Thyroid function and antithyroid antibodies were screened if not obtained in the previous year.Main Outcome Measures: Extent of disease and markers of autoimmunity or autoinflammation.Results: Of the 553 patients, 130 had halo nevi-NSV and 423 had NSV. Family history of premature hair graying (odds ratio, 1.74; P<.01) was positively associated with halo nevi-NSV by univariate analysis. Using multivariate analysis, age at onset younger than 18 years, phototype, total body area, localization on the trunk, involvement of hands and feet, and total staging were found to be independent factors. Age at onset younger than 18 years; phototypes I, II, and III; trunk involvement; and staging were positively associated with halo nevi-NSV, whereas this association was negative for total affected area and involvement of hands and feet.Conclusions: Halo nevi association in NSV affects age at onset and depigmentation pattern and has a stronger link with familial premature hair graying, suggesting that premature hair graying may involve, at least partly, an autoimmune pathway.