Visual and auditory abnormalities in patients with nonsegmental vitiligo

Background: Melanocytes, the key cells in vitiligo, exist in many organs other than skin. Their dysfunction in the skin occurs in vitiligo and there is controversial evidence of involvement of other sites. Objective: The aim of this study was to investigate the structure and/or function of two of the organ systems containing melanocytes; eyes and ears, to detect any impairment in nonsegmental vitiligo patients. Patients and methods: Sixty patients with nonsegmental vitiligo and 20 control patients who were aged and whose sex matched were included. All the patients were subjected to clinical examination and Vitiligo Area Severity Index (VASI) scoring. All patients underwent: fundus and slit-lamp examination, electroretinogram, visual-evoked potentials and audiometric measurements. Results: The patient group was divided into group A; 36 patients with less than 50% body surface involvement, and group B; 24 patients with more than 50% body surface involvement. All investigations pertaining to involvement of pigment cells in the eyes were negative in all patients and controls. Auditory disturbances as evaluated by audiometry revealed statistically nonsignificant involvement; bilateral in seven patients and unilateral in one (15 ears), with no significant difference between both groups, and was normal in controls. Although there was a statistically significant difference between groups A and B regarding disease duration and VASI score, this difference had no impact on hearing loss. Conclusion: In nonsegmental vitiligo patients, population of higher skin types of various extent and both sexes, impairment of pigment cells in the visual apparatus could not be detected, whereas auditory abnormalities were detected through audiometry in 13.3%. It is therefore important in those patients to guard against further otological damage, by avoidance of high noise jobs or ototoxic drugs and by considering routine audiometric check-ups.