Effect of chemical exposure in induction and evolution of vitiligo: Correlation between duration of exposure and disease, site of exposure and onset, and impact upon avoidance

Abstract Background The exogenous oxidants can trigger and lead to progression and chronicity in idiopathic vitiligo similar to chemical leucoderma and contact vitiligo. Aims The basic objectives of this study were to study chemical exposure history in vitiligo patients and to correlate this with induction or progression of lesions. Methods This prospective observational study with intervention in the form of avoidance of exposure was conducted at MGM Medical College, Bihar at eastern India during the period of September 2010 to April 2012. Detailed record of demographic and clinical features was noted with specific chemical exposure especially duration of exposure, site of exposure, and outcome of the disease upon avoidance of chemicals. Results The proportion of cases coming to the OPD with vitiligo was 1.03% ( n =241) among total 23,410 outpatients department's dermatological patients. History of household chemical exposure and industrial (occupational) chemical exposure was found in 94.6% ( n =228) and 0.4% ( n =1) patients, respectively. The duration of disease and duration of chemical exposure had no correlation ( r =+0.1756). Regarding avoidance of chemical exposure on the progression of vitiligo, the difference between fully compliant versus noncompliant was statistically significant ( p p >0.05). Correlation of site of chemical exposure with site of onset of disease was found in 64.9% ( n =148) patients. Conclusions Chemical triggering factors play very significant role in induction and progression of vitiligo.