title: Relationship between Helicobacter pylori infection and vitiligo: a prospective study.
abstract: BACKGROUND
  Helicobacter pylori is a worldwide bacteria that may affect several extra-gastric systems, including the endocrine, hematologic, vascular, respiratory, immune, and skin. Several skin diseases, including chronic urticaria, alopecia areata, psoriasis, and systemic lupus erythematosis have been found to be associated with H. pylori infection.
  
  
  OBJECTIVE
  To our knowledge, there are no data showing an association between H. pylori and vitiligo. Therefore, in this study, we wanted to evaluate the relationship between H. pylori and vitiligo.
  
  
  METHODS
  This study is a prospective study carried out in our Gastroenterology and Dermatology and Venereology departments of the Ankara Education and Research Hospital (Ankara, Turkey) between July 2013 and December 2013. Seventy-nine consecutive patients with vitiligo and 72 patients with telogen effluvium (TE) were recruited from the dermatology outpatient clinic. A total of 133 patients with vitiligo (n=68) and TE (n=65) [excluding 18 patients who had suspicious urea breath test (UBT) results] were included in the study. All individuals were tested for H. pylori IgG and CagA. Also, a UBT was performed to detect the presence of H. pylori infection.
  
  
  RESULTS
  There were significantly higher rates of H. pylori positivity, H. pylori CagA, and IgG in serum in the vitiligo group than in the TE group (p<0.05). The number of patients with dyspepsia was significantly higher in the vitiligo group than in the TE group. No statistically significant relationship was seen between H. pylori positivity, CagA, H. pylori IgG, dyspepsia, and the Vitiligo Disease Activity score (p>0.05). Also, when patients with vitiligo were divided into localized and generalized types of vitiligo, there was no association between vitiligo involvement pattern and H. pylori positivity, CagA, H. pylori IgG, and dyspepsia (p>0.05).
  
  
  CONCLUSIONS
  Additional studies are necessary to evaluate the effect of H. pylori eradication on the clinical course of vitiligo. Further studies are also needed to explain the relationship between H. pylori and the pathogenesis of vitiligo.
authors.affiliation: Department of Gastroenterology, Ankara Training and Research Hospital, Sukriye District, Ulucanlar Street, Altındağ, Ankara 06230, Turkey, doganzeynal@yahoo.com.
authors.forename: Zeynal
authors.initials: Z
authors.lastname: Doğan
authors.forename: Pınar
authors.initials: P
authors.lastname: Özdemir
authors.forename: Meral
authors.initials: M
authors.lastname: Ekşioğlu
authors.forename: Levent
authors.initials: L
authors.lastname: Filik
mesh_terms: D000328:Adult; D000505:Alopecia / Q000382:microbiology*; D000942:Antigens, Bacterial / Q000097:blood; D001426:Bacterial Proteins / Q000097:blood; D001944:Breath Tests / Q000379:methods; D004415:Dyspepsia / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014421:Turkey; D014508:Urea / Q000032:analysis; D014820:Vitiligo / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D007074:Immunoglobulin G; C080866:cagA protein, Helicobacter pylori; D014508:Urea