Serum homocysteine level in vitiligo patients

Background: Vitiligo is a common cutaneous depigmentation disorder caused by the destruction of melanocytes. The exact etiopathogenesis of this disorder is not well known, but a complex of genetic, immunologic, inflammatory, and cytotoxic factors have been implicated. According to reports on the role of vitamin B12 and folic acid deficiency as important co-factors in the metabolism of homocysteine, we expected an increase in homocysteine levels in patients with vitiligo; therefore, our aim was to investigate the serum levels of homocysteine in Iranian patients with vitiligo. Method: Forty patients with vitiligo and 40 healthy controls matched for age and sex were studied. After exclusion of cases with diseases that could affect the homocysteine level, serum homocysteine levels were measured by ELISA. Result: Males comprised 57.5% of the participants in both groups and 42.5% were female. The mean age of the patients was 24.68 ± 12.44 years. The level of homocysteine in the case and control groups was 18.56 ± 5.69 and 10.19 ± 4.40, respectively, which was significantly higher in patients with vitiligo (P ≤ 0.001). There was no correlation between homocysteine levels and age, sex, history of previous treatment, duration of disease, and the extent of body surface involvement. Serum homocysteine levels in patients with regressive vitiligo (13.8) were lower than progressive (18.4) and stable (20.4) cases (P = 0.05). Conclusion: We found that the increase in serum homocysteine level in patients genetically susceptible to vitiligo could be a predisposing factor for the development of vitiligo. The serum homocysteine level may be associated with disease activity, and may be used as a prognostic factor for disease activity.