SciELO - Scientific Electronic Library Online

 
vol.94 número4Efficacy and safety of biosimilar infliximab CT-P13 in the treatment of psoriasis and psoriatic arthritis: 1-year follow-upTelogen effluvium x female pattern hair loss: is there correlation? índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Journal

Artigo

Indicadores

Links relacionados

Compartilhar


Anais Brasileiros de Dermatologia

versão impressa ISSN 0365-0596versão On-line ISSN 1806-4841

An. Bras. Dermatol. vol.94 no.4 Rio de Janeiro jul./ago. 2019  Epub 17-Out-2019

https://doi.org/10.1590/abd1806-4841.20198391 

Letters

P-wave dispersion in vitiligo patients*

1Skin Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2Department of Cardiology, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.


Dear Editor,

Vitiligo is an acquired depigmentation disorder of unknown origin.1 Melanocytes are found in the heart valves and septum, the atrium, and the vessels, with possible role in abnormal signals and atrial arrhythmia.2 P-wave dispersion (PWD) is the difference between P-max and P-min in 12-lead electrocardiography.3 Assessment of possible risk is useful, especially regarding the accessibility of electrocardiography in all health care centers and the possible association between some electrocardiogram (ECG) alterations and the presence of arrhythmia, even in healthy subjects. Hence, the purpose of this study was to determine the PWD in vitiligo patients vs. control subjects. A case-control study was performed in a referral dermatology outpatient clinic in Shohada-e-Tajrish Hospital, affiliated with the Shahid Beheshti University of Medical Sciences, Tehran, Iran, during a one-year period (October 2016 to October 2017). A total of 94 participants were included in this study, i.e., 47 patients with vitiligo and 47 healthy volunteers. The exclusion criteria were history of other diseases, smoking, and obesity. The medical assessment involved natural and Wood’s light examinations consistent with the modified Vitiligo European Task Force form. Based on the Vitiligo European Task Force, a patient’s palm, corresponding to 1% of body surface area, was used to calculate the total vitiligo extension. The P-max and P-min were calculated in all 12 ECG leads and the difference between them was defined as the PWD. Data analysis was performed using SPSS (v 18.0) software, utilizing the chi-squared test and Student’s t-test for independent samples. Statistically significant p-values were those less than 0.05. In each group, 32 patients were female. The mean (standard deviation) age was 34.9 (12.1) and 32.8 (11.3) years in the case and control groups, respectively (p > 0.05). The vitiligo type was vulgaris in 87.2% and acrofacial in 12.8%. The mean involved body area by vitiligo in case group was 30%. The results in Table 1 demonstrate that PWD was alike across the case groups (p > 0.05). The EF, heart rate, and blood pressures had no significant differences (p > 0.05). Baldini et al. reported that vitiligo has been associated with other rare systemic disorders.4 However, there was no significant association in the present study. Fairfax et al. found an association between vitiligo, primary hypothyroidism, pernicious anemia, and idiopathic chronic heart block.5 In sum, it may be concluded that PWD in vitiligo patients vs. control subjects is not significantly differed. Hence, there is no screening requirement for cardiovascular disorders in patients with vitiligo.

Table 1 P-max, P-min, and P-wave dispersion (PWD) across the groups 

P-max P-min PWD
Mean Standard deviation Mean Standard deviation Mean Standard deviation
Case 100.00 12.06 44.17 4.25 55.83 11.65
Control 100.17 10.52 45.70 3.89 54.47 9.85

*Study conducted at the Department of Cardiac Aspects of Skin Diseases, Skin Research Center, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Financial support: None.

ACKNOWLEDGMENTS

The authors would like to thank the patients participating in this study.

REFERENCES

1 Parker CN, Finlayson KJ, Shuter P, Edwards HE. Risk factors for delayed healing in venous leg ulcers: a review of the literature. Int J Clin Pract. 2015;69:967-77. [ Links ]

2 Fernandez ML, Upton Z, Shooter GK. Uric acid and xanthine oxidoreductase in wound healing. Curr Rheumatol Rep. 2014;16:396. [ Links ]

3 Fernandez ML, Upton Z, Edwards H, Finlayson K, Shooter GK. Elevated uric acid correlates with wound severity. Int Wound J. 2012;9:139-49. [ Links ]

4 Hoffmeister C, Trevisan G, Rossato MF, de Oliveira SM, Gomez MV, Ferreira J. Role of TRPV1 in nociception and edema induced by monosodium urate crystals in rats. Pain. 2011;152:1777-88. [ Links ]

5 Burnand KG, Whimster I, Naidoo A, Browse, NL. Pericapillary fibrin in the ulcer-bearing skin of the leg: the cause of lipodermatosclerosis and venous ulceration. Br Med J (Clin Res Ed). 1982;285:1071-2. [ Links ]

Received: April 24, 2018; Accepted: August 30, 2018

Mailing Address: Soma Ahmadi. E-mail: communitymedicineiran.health@gmail.com

Conflict of interest: None.

AUTHORS’ CONTRIBUTIONS

Soheila Nasiri

0000-0003-1413-2453

Data collection, analysis and interpretation; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases.

Mehdi Pishgahi

0000-0001-8834-7751

Approval of the final version of the manuscript; study design and planning; critical literature review.

Soma Ahmadi

0000-0003-3896-9717

Statistical analysis; approval of the final version of the manuscript; study design and planning; manuscript preparation and writing; data collection, analysis and interpretation; effective participation as research advisor; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical literature review; critical manuscript review.

Sahar Dadkhahfar

000-0002-6054-4646

Data collection, analysis and interpretation; effective participation as research advisor.

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License which permits unrestricted noncommercial use, distribution, and reproduction in any medium provided the original work is properly cited.