論文發表

Question 1

先進皮膚成像系統在診斷面部色素性和炎症性疾病中的比較研究

Accepted Answer

摘要: 視覺評估雖然是臨床實踐中評估色素沉著和紅斑的主要方法，但它具有主觀性、耗時性，且可能導致臨床醫師之間觀察結果的差異。為了準確評估疾病的嚴重程度和治療的有效性，需要客觀且量化的技術。本研究檢驗了一種新開發的皮膚成像系統在評估色素沉著和紅斑方面的精確度和實用性。研究招募了60名參與者，並使用新型OBSERV 520 x皮膚成像系統對其面部圖像進行分析，與DERMACATCH進行區域分析和VISIA進行全臉檢查進行比較。皮膚色素沉著的程度通過皮膚科醫生評估的MASI分數進行臨床分級。數據顯示，新型皮膚成像系統與兩種傳統儀器在量化色素沉著和紅斑方面存在正相關，無論是在區域分析還是全臉分析中。此外，新型皮膚成像系統與臨床MASI分數之間也存在正相關（r = 0.4314, P < 0.01）。相比之下，我們的研究發現傳統系統與臨床評估之間沒有顯著相關性，表明新系統在評估色素過度沉著方面具有更強的能力。我們的研究驗證了這種創新皮膚成像系統在評估色素沉著和紅斑方面的準確性，展示了其在臨床和研究目的中進行量化評估的可行性。 Visual assessment, while the primary method for pigmentation and erythema evaluation in clinical practice, is subjective, time-consuming, and may lead to variability in observations among clinicians. Objective and quantitative techniques are required for a precise evaluation of the disease's severity and the treatment's efficacy. This research examines the precision and utility of a newly developed skin imaging system in assessing pigmentation and erythema. Sixty participants were recruited, and their facial images were analyzed with the new OBSERV 520 x skin imaging system, compared to DERMACATCH for regional analysis and VISIA for full-face examination. The degree of skin pigmentation was clinically graded using the MASI scores evaluated by dermatologists. The data revealed positive correlations between the novel skin imaging system and the two conventional instruments in quantifying pigmentation and erythema, whether in regional or full-face analysis. Furthermore, the new skin imaging system positively correlated with the clinical MASI scores (r = 0.4314, P < 0.01). In contrast, our study found no significant correlation between the traditional system and clinical assessment, indicating a more substantial capacity for hyperpigmentation assessment in the new system. Our study validates the innovative skin imaging system's accuracy in evaluating pigmentation and erythema, demonstrating its feasibility for quantitative evaluation in both clinical and research purposes.

Question 2

從零到一：白斑症發病機理、診斷和治療的最新進展

Accepted Answer

摘 要： 白斑症是最常見的後天性色素障礙，對患者的心理社會影響深遠。白斑症的病程通常不可預測，診斷和治療白斑症依然是皮膚科的一大挑戰。在本綜述中，我們介紹了白斑症發病機理的新進展，討論了可能有助於醫生評估白斑症病情活動性和嚴重程度的新興生物標誌物，並總結了白斑症治療中前景看好的靶向療法。此外，還簡要概述了2019冠狀病毒病（COVID-19）大流行對白斑症患者的影響。我們希望讀者能夠更全面地了解白斑症，並對新的診斷工具和治療選擇有所啟發。 Vitiligo is the most common acquired pigmentary disorder and can have profound negative psychosocial impacts on patients. The disease course of vitiligo is often unpredictable, and diagnosis and treatment of vitiligo remain a challenging dermatological task. In this review, we touch on new advances in understanding vitiligo pathogenesis; discuss emerging biomarkers that may aid physicians in assessing vitiligo disease activity and severity, and summarize prospective targeted therapies in treating vitiligo. A brief outline dedicated to the impact of the coronavirus disease 2019 pandemic on vitiligo patients is also provided. We hope that readers may acquire a more comprehensive understanding of vitiligo and gain insights into new diagnostic tools and therapeutic options for vitiligo. 閱讀論文

Question 3

皮膚間質液和血漿多重細胞因子分析顯示IFN-γ特徵及Granzyme B作為評估白斑症活動性、嚴重性和預後的有用生物標誌物

Accepted Answer

摘 要： **背景：** 白斑症的病程不可預測，經常出現病情惡化和長期恢復期。因此，建立一個替代標誌物來預測疾病活動性、嚴重性和預後的生物標誌物譜是至關重要的。最近，使用局部皮膚間質液作為生物標誌物引起了人們的興趣，但關於皮膚間質液、血漿與疾病過程之間關聯的廣泛研究仍然缺乏。本研究旨在評估皮膚和血漿中的細胞因子表達譜，並探討該生物標誌物面板在評估白斑症患者疾病活動性、嚴重性和預後中的實用性。 **方法：** 在這項前瞻性隊列研究中，我們從2019年3月到2021年9月期間，在一家三級醫療中心的門診部招募了86名患者和34名健康對照者。所有患者均為亞洲人種。兩名獨立的調查員對疾病活動性和嚴重性進行了評估，並進行了為期12個月的縱向隨訪以評估治療反應。使用超敏多重細胞因子面板和單分子計數技術免疫測定法研究皮膚間質液和血漿中的細胞因子表達。 **結果：** 與健康對照組相比，白斑症患者的病變皮膚間質液和血漿中IFN-γ及其標誌性細胞因子，包括CXCL9、CXCL10和顆粒酶B（GzmB）表達最高。相比之下，IL-1β、IL-13、IL-15、IL-17A和IL-18的表達沒有顯著變化。受試者工作特徵（ROC）分析顯示，IFN-γ是預測疾病活動性的最敏感和特異的標誌物，其次是CXCL10和GzmB。CXCL9在診斷白斑症疾病嚴重性方面具有敏感性和特異性。IFN-γ表達水平的下降與治療反應呈正相關。 **結論：** 在白斑症患者的病變皮膚和血漿中，IFN-γ、CXCL9、CXCL10和GzmB表達水平較高，可能作為臨床活動性、嚴重性和預後預測的生物標誌物。在所有標誌物中，IFN-γ在疾病活動性和治療反應預測方面具有最高的預測價值，支持了IFN-γ在白斑症發病機制中的關鍵作用。 Background: The course of vitiligo is unpredictable, with periods of disease flare-ups and prolonged recovery periods. It is essential to establish a biomarker profile as a substitute marker for disease activity to predict disease activity, severity, and prognosis prediction. The use of localized skin interstitial fluid as biomarkers has recently gained interest, but extensive studies of the association between skin interstitial fluid, plasma, and the disease course is lacking. This study aims to evaluate the cytokine expression profiles in the skin and plasma and the utility of the biomarker panel in assessing disease activity, severity, and prognosis in patients with vitiligo. Methods: In this prospective cohort study, 86 patients and 34 healthy controls were recruited from the outpatient department of a tertiary medical center from March 2019 to September 2021. All patients were of Asian ethnicity. Two independent investigators evaluated disease activity and severity with longitudinal follow-ups for treatment response for a-12 month period. Ultrasensitive multiplex cytokine panel and single-molecule counting technology immunoassays were used to study the cytokine expression in skin interstitial fluid and plasma. Results: IFN-γ and its’ signature cytokines, including CXCL9, CXCL10, and GzmB, are most highly expressed in the vitiligo patients’ lesion skin interstitial fluid and plasma compared to healthy control. By way of comparison, no significant changes in IL-1β, IL-13, IL-15, IL-17A, IL-18 were observed. Receiver operating characteristic analysis revealed that IFN-γ is the most sensitive and specific marker in predicting disease activity, followed by CXCL10 and GzmB. CXCL-9 was sensitive and specific in diagnosing vitiligo disease severity. The decrease in IFN-γ expression level is positively correlated with the treatment response. Conclusion: IFN-γ, CXCL9, CXCL10, and GzmB are highly expressed in vitiligo patients’ lesion skin and plasma and may serve as biomarkers for the clinical activity, severity, and prognosis prediction in vitiligo patients. Among all, IFN-γ exerts the highest predictive value in disease activity and treatment response, supporting the critical role of IFN-γ in the pathogenesis of vitiligo. 閱讀論文

Question 4

針對白斑症患者中升高的IFN-γ進行人類抗IFN-γ 單株抗體生物製劑治療可抑制對黑色素細胞的直接細胞毒性

Accepted Answer

摘 要： 白斑症是一種自身免疫性疾病，會逐漸破壞皮膚中的黑色素細胞，導致斑駁的脫色。已有報告指出IFN-γ和CXCL10對白斑症中黑色素細胞的直接病理作用，但關於哪種細胞因子對黑色素細胞具有關鍵的細胞毒性效果，結果存在矛盾。 我們獲取了白斑症患者病變區和非病變區皮膚以及健康對照的間質液分析物，並進行了高靈敏度多重細胞因子檢測。我們還進行了功能研究，以確定高表達細胞因子的直接毒性效果。我們發現白斑症皮膚中IFN-γ、CXCL9、CXCL10和CXCL11顯著升高。離體黑色素細胞研究支持IFN-γ本身對黑色素細胞的直接作用，導致細胞丟失、氧化應激增加和黑素生成中斷。有趣的是，我們發現IFN-γ通過與氧化應激相關的鐵死亡途徑調節細胞死亡，這可能引發白斑症中的自身免疫反應。與選擇性阻斷細胞死亡途徑不同，我們的體外研究支持人類抗IFN-γ單克隆抗體2A6Q通過中斷IFN-γ信號傳導來緩解IFN-γ誘導的黑色素細胞死亡、氧化應激和功能喪失，這可能是白斑症的潛在治療選擇。 Vitiligo is an autoimmune disease that progressively destroys melanocytes in theskin, resulting in patchy disfiguringdepigmentation. The direct pathologicaleffect of IFN-γ,CXCL10 to the melanocytesin vitiligo has been reported, but there arecontradictory results to which cytokineexerts the critical cytotoxic effect onmelanocytes.We obtained the interstitial fluid analytefrom lesion and non-lesion skin of vitiligopatients and healthy control and sent forhigh sensitivity multiplex cytokine panel. Wefurther performed functional study toidentify the direct toxicity effect of the highlyexpressed cytokines.We found a significant elevation of IFN-γ,CXCL9, CXCL10, CXCL11 in the vitiligoskin. Ex vivo melanocyte studies supportthe directrole of IFN-γper se in melanocytecell loss, increased oxidative stress andmelanogenesis disruption. Interestingly, wefound that IFN-γregulated cell deaththrough oxidative stress-related ferroptosiscell death, which may initiate autoimmunityin vitiligo. In contrast to blocking selectedcell death pathway, our in vitro studysupports the rescue effect of human anti-IFN-γmonoclonal antibody 2A6Q to IFN-γinduced cell death, oxidative stress, andloss of function in melanocytes byinterrupting IFN-γsignaling, which may bea potential therapeutic option for vitiligo. 閱讀論文

Question 5

致病性抗IFN-γ自身抗體通過阻礙受體組裝和介導的Fc反應起作用

Accepted Answer

摘 要： 抗干擾素（IFN）-γ自身抗體（AIGAs）是晚發性免疫缺陷伴彌漫性分枝桿菌和其他機會性感染的致病因素。AIGAs會阻斷IFN-γ的功能，但它們對IFN-γ信號傳導的影響尚不清楚。使用單細胞捕獲方法，我們從具有AIGAs的患者中分離出19種對IFN-γ有反應的單克隆抗體（mAbs）。所有抗體均顯示出對IFN-γ的高親和力（KD < 10^-9 M），但僅有八種中和了IFN-γ-STAT1信號傳導和HLA-DR表達。信號阻斷和結合親和力相關，並歸因於體細胞超突變。交叉競爭試驗鑑定出AIGAs在IFN-γ上的三個不重疊的結合位點（I-III）。 我們發現，位點I的mAb通過阻止IFN-γ與IFN-γR1的結合來中和IFN-γ。位點II和III的mAbs在細胞表面結合受體結合的IFN-γ，破壞IFN-γR1-IFN-γR2異二聚體化，從而阻止下游信號傳導。位點III的mAbs通過抗體-IFN-γ複合物在細胞上介導抗體依賴的細胞毒性。致病性AIGAs通過雙重阻斷IFN-γ信號傳導和消除對IFN-γ有反應的細胞，導致分枝桿菌感染。 Anti-interferon (IFN)–γ autoantibodies (AIGAs) are a pathogenic factor in late-onset immunodeficiency with disseminated mycobacterial and other opportunistic infections. AIGAs block IFN-γ function, but their effects on IFN-γ signaling are unknown. Using a single-cell capture method, we isolated 19 IFN-γ–reactive monoclonal antibodies (mAbs) from patients with AIGAs. All displayed high-affinity (KD < 10−9 M) binding to IFN-γ, but only eight neutralized IFN-γ–STAT1 signaling and HLA-DR expression. Signal blockade and binding affinity were correlated and attributed to somatic hypermutations. Cross-competition assays identified three nonoverlapping binding sites (I–III) for AIGAs on IFN-γ. We found that site I mAb neutralized IFN-γ by blocking its binding to IFN-γR1. Site II and III mAbs bound the receptor-bound IFN-γ on the cell surface, abolishing IFN-γR1–IFN-γR2 heterodimerization and preventing downstream signaling. Site III mAbs mediated antibody-dependent cellular cytotoxicity, probably through antibody–IFN-γ complexes on cells. Pathogenic AIGAs underlie mycobacterial infections by the dual blockade of IFN-γ signaling and by eliminating IFN-γ–responsive cells. 閱讀論文

Question 6

口服氨甲環酸（TA）治療白斑症合併黃褐斑的可行性

Accepted Answer

摘 要： 雀斑和白斑症都是常見的色素性疾病，其治療具有挑戰性。口服氨甲环酸（TA）對難治性雀斑有效；然而，對於合併雀斑的白斑症患者的TA的可行性尚未研究。為評估口服TA治療白斑症患者雀斑的治療結果和不良反應。我們對2017年1月至2020年8月間在三級皮膚科中接受口服TA治療雀斑的白斑症患者進行了回顧性分析。我們納入了32名同時患有白斑症和面部雀斑的患者。患者報告的雀斑改善的平均持續時間約為1.64個月的治療。白斑症病灶再色素沉著的首次跡象發生在治療1個月時。84.38%的患者在醫師全球評估中達到了輕度至良好程度的雀斑改善（0%–75%改善），而81.25%的患者通過醫師全球評估達到了中度至優良程度的白斑症改善（25%–100%改善）。未觀察到明顯的不良事件。在TA治療期間，未有患者出現白斑症疾病惡化。口服TA可能是白斑症患者雀斑治療的可行選擇。 Melasma and vitiligo are both common pigmentary disorders, and the treatment is challenging. Oral tranexamic acid (TA) is effective for refractory melasma; however, the feasibility of TA in vitiligo patients with melasma was not studied. To evaluate the treatment outcomes and adverse effects of oral TA in vitiligo patients with melasma. We conducted a retrospective analysis of vitiligo patients who received oral TA for melasma in a tertiary dermatologic center from January 2017 to August 2020. We enrolled 32 patients with concomitant vitiligo and melasma on the face. The mean duration of the improvement of melasma that patients reported is around 1.64 months of treatment. The first sign of repigmentation of the vitiligo lesions occurred at 1 month of treatment. 84.38% of the patients achieved a mild to good degree of improvement of melasma (0%–75% improvement), whereas 81.25% of the patients achieved a moderate to excellent degree of improvement of vitiligo (25%–100% improvement) via physician global assessments. No significant adverse event was noted. No patients experience vitiligo disease deterioration during TA treatment. Oral TA may be a feasible option for melasma in vitiligo patients. 閱讀論文

Question 7

穩定性白斑症表皮色素移植術與自動表皮微移植術的比較研究

Accepted Answer

摘 要： 自動吸疱表皮微移植術（ABEM）是一種新引入的難治性白斑症的外科移植方法，然而，對其他外科方法的比較分析仍然缺乏。我們進行了一項回顧性研究，將ABEM與傳統吸疱表皮移植術（SBEG）的療效、安全性和操作經驗進行比較。研究共納入了75名患者的118個解剖部位的白斑症病變。主要評估結果為再色素沉著的程度，並評估了患者和操作人員的經驗。根據醫師綜合評估（PGA），SBEG在再色素沉著的發生率方面顯著更高（p < 0.001），尤其是在面部/頸部區域（p < 0.001），並且在白斑症面積評分指數（VASI）上也有顯著改善。相反，ABEM具有較短的供皮區採集時間，更好的患者手術體驗以及更顯著的皮膚病生活質量指數（DLQI）改善。 在10名患者的38個病變中，同時接受了SBEG和ABEM，發現在相同的受體區域內再色素沉著的程度沒有差異。總體而言，SBEG的再色素沉著程度高於ABEM，特別是在活動區域，而且成本更低。相反，ABEM需要較少的操作學習曲線，可以提供更大的移植區域，並且供皮區恢復時間較短。了解這兩種吸疱移植術的優缺點對於白斑症移植的最佳手術結果至關重要。 The automated blister epidermal micrograft (ABEM) is a newly introduced surgical transplantation for refractory vitiligo. Comparative analysis of other surgical methods is lacking. We conducted a retrospective study to compare the efficacy, safety, and experience of ABEM with conventional suction blister epidermal graft (SBEG). A total of 118 anatomically based vitiligo lesions from 75 patients were included. The primary outcome was the degree of repigmentation; the patient and operator experience were evaluated. SBEG had a significantly greater incidence of repigmentation (p < 0.001), as measured by the Physician Global Assessment, as well as improvements in the Vitiligo Area Scoring Index, particularly on the face/neck area (p < 0.001). ABEM, on the contrary, had reduced donor harvest time, a better patient operative experience, and more significant Dermatology Life Quality Index improvements. In a subgroup of 38 lesions from ten patients who received both SBEG and ABEM concomitantly, there was no difference in the degree of repigmentation in the same recipient area. Overall, the degree of repigmentation for SBEG is higher than ABEM, especially in the mobilized region, and the cost is less expensive. On the contrary, ABEM requires less procedure learning curve and can supply a greater transplanting zone with shorter donor site recovery. Understanding the benefits and drawbacks of two blister grafting procedures is essential for optimal surgical outcomes for vitiligo grafting. 閱讀論文

Question 8

穩定型分節型與非分節型白斑症患者的表皮色素移植療效和安全性

Accepted Answer

摘 要： 白斑症是一種常見且對心理造成嚴重影響的色素障礙疾病。當藥物治療無效時，外科移植常用於治療穩定型白斑症。自動表皮微移植採集（AEMH）系統最初設計用於治療創傷，但僅有少數研究探討了AEMH在白斑症中的應用。本研究旨在調查AEMH系統在穩定型節段性和非節段性白斑症患者中的療效和安全性。我們每兩個月記錄一次再色素沉著率和不良事件，持續至少12個月。根據患者特徵、白斑症亞型和不同解剖位置分析療效。研究共納入34名患者的56個色素脫失病灶。95.50%的自動表皮微移植物成功移植到受體部位。接受AEMH治療的患者在白斑症面積評分指數（VASI）和皮膚病生活質量指數（DLQI）上有顯著改善（p < 0.001）。VASI評分顯示，再色素沉著率從治療前的96.25 ± 8.59提高到治療後的48.30 ± 28.16（p < 0.001）。節段性和穩定型非節段性白斑症患者之間的治療效果相當。面部和頸部區域效果最好，其次是軀幹（胸部、腹部、背部和腋窩），四肢區域次之，而末端區域效果最差（p < 0.014）。總的來說，AEMH在穩定型白斑症患者中是一種有效且不良事件有限的治療方法。這種採集方法可能成為白斑症手術治療的可行選擇。 Vitiligo is a common, psychologically devastating pigmentary disorder. Surgical graftings are used to treat stable vitiligo when medical treatment fails. An automated epidermal micrograft harvesting (AEMH) system was first designated to treat wounds, and very few studies investigated the application of AEMH in vitiligo. In this study, we investigated the efficacy and safety of the AEMH system in patients with stable segmental and nonsegmental vitiligo. The rate of repigmentation and adverse events was recorded bimonthly for at least 12 months. We analyzed the efficacy based on patient characteristics, vitiligo subtypes, and different anatomical locations. A total of 56 depigmented lesions from 34 patients were included. 95.50% of the automated epidermal micrografts were successfully grafted at the recipient sites. There was a significant improvement in Vitiligo Area Scoring Index (VASI) and Dermatologic Life Quality Index (DLQI) in patients treated with AEMH (p < 0.001). The rate of repigmentation by VASI score improves from 96.25 ± 8.59 to 48.30 ± 28.16 after the treatment (p < 0.001). Treatment outcomes were comparable between the patients of segmental and stable nonsegmental vitiligo. The face and neck region achieved a better outcome, followed by the trunk (chest, abdomen, back, and axilla), limbs, and the worse outcome was found in the acral region (p < 0.014). Conclusively, AEMH is an effective treatment procedure with limited adverse events in patients with stable vitiligo. This harvesting method may be a feasible option for vitiligo surgical treatment. 閱讀論文

Question 9

高細胞分辨率全視場人工智能輔助實時光學同調斷層掃描術在白斑症評估中的可行性：一項前瞻性縱向隨訪研究

Accepted Answer

摘 要： 白斑症是一種令患者心理壓力巨大的色素性疾病，其特徵是由於黑色素細胞的丟失而在皮膚上出現白色脫色斑塊。針對白斑症的早期檢測和治療反應監測，需要非侵入性工具。高細胞分辨率全視場光學同調斷層掃描術（CRFF-OCT）在色素性疾病評估中日益受到關注，但其在組織移植後白斑症再色素化中的應用尚未得到探索。為了研究 CRFF-OCT 評估組織移植後白斑症病變的可行性，我們對 2021 年至 2022 年期間在一級醫療中心接受水泡表皮移植和雷射磨皮的十名白斑症患者進行了研究。在為期六個月的研究中，記錄了臨床特徵、皮膚鏡檢和攝影數據。利用 CRFF-OCT 和人工智能（AI）應用，捕捉並分析了再色素化特徵。CRFF-OCT 分析顯示，白斑症病變皮膚中出現了一條明顯的黑色帶，表明黑色素流失。移植區域在表皮-真皮交界處和毛囊周圍出現了帶樹突的黑色素細胞。CRFF-OCT 證明其在早期檢測黑色素細胞恢復和準確量化黑色素方面的有效性。本研究介紹了 CRFF-OCT 作為實時、非侵入性和體內評估工具在白斑症再色素化中的應用，為色素性疾病和治療反應提供了寶貴的見解。 Vitiligo, a psychologically distressing pigmentary disorder characterized by white depigmented patches due to melanocyte loss, necessitates non-invasive tools for early detection and treatment response monitoring. High-cellular-resolution full-field optical coherence tomography (CRFF-OCT) is emerging in pigmentary disorder assessment, but its applicability in vitiligo repigmentation after tissue grafting remains unexplored. To investigate the feasibility of CRFF-OCT for evaluating vitiligo lesions following tissue grafting, our investigation involved ten vitiligo patients who underwent suction blister epidermal grafting and laser ablation at a tertiary center between 2021 and 2022. Over a six-month period, clinical features, dermoscopy, and photography data were recorded. Utilizing CRFF-OCT along with artificial intelligence (AI) applications, repigmentation features were captured and analyzed. The CRFF-OCT analysis revealed a distinct dark band in vitiligo lesion skin, indicating melanin loss. Grafted areas exhibited melanocytes with dendrites around the epidermal-dermal junction and hair follicles. CRFF-OCT demonstrated its efficacy in the early detection of melanocyte recovery and accurate melanin quantification. This study introduces CRFF-OCT as a real-time, non-invasive, and in vivo evaluation tool for assessing vitiligo repigmentation, offering valuable insights into pigmentary disorders and treatment responses. 閱讀論文

Question 10

多發性硬化症與白斑症的關聯：系統性回顧

Accepted Answer

摘 要： 多自體免疫性意味著一些自體免疫性疾病共享相同的病因。一些研究報告了多發性硬化（MS）和白斑症之間的關聯性；同時，其他研究未能證實此關聯性。我們進行了一項系統性回顧和荟萃分析，以檢視MS與白斑症的關聯性。我們於2020年3月8日在MEDLINE和Embase數據庫中搜索了相關的病例-對照、橫斷面和群體研究。使用Newcastle-Ottawa Scale評估了包括在內的研究的偏倚風險。在適用的情況下，我們進行了荟萃分析，計算了病例-對照/橫斷面研究的總體勝算比（OR）和群體研究的風險比，並附帶95%的置信區間（CI）。我們的搜索在去除重複引文後識別了285個引文。符合我們的納入標準的有6個病例-對照研究，共有12,930名受試者。我們的荟萃分析發現，MS與既往的白斑症沒有顯著的關聯性（總體OR 1.33；95% CI 0.80‒2.22）。對總體數據的分析未顯示MS患者中既往白斑症的增加與對照組相比。族裔和基因因素可能對偶發觀察到的MS和白斑症之間的關聯性起重要作用。因此，將來的研究應該考慮按族裔或基因因素進行分層。 Polyautoimmunity implicates that some autoimmune diseases share common etiopathogenesis. Some studies have reported an association between multiple sclerosis (MS) and vitiligo; meanwhile, other studies have failed to confirm this association. We performed a systemic review and meta-analysis to examine the association of MS with vitiligo. We searched the MEDLINE and Embase databases on March 8, 2020 for relevant case–control, cross-sectional, and cohort studies. The Newcastle–Ottawa Scale was used to evaluate the risk of bias of the included studies. Where applicable, we performed a meta-analysis to calculate the pooled odds ratio (OR) for case–control/cross-sectional studies and risk ratio for cohort studies with 95% confidence interval (CI). Our search identified 285 citations after removing duplicates. Six case–control studies with 12,930 study subjects met our inclusion criteria. Our meta-analysis found no significant association of MS with prevalent vitiligo (pooled OR 1.33; 95% CI 0.80‒2.22). Analysis of the pooled data failed to display any increase of prevalent vitiligo in MS patients compared with controls. Ethnic and genetic factors may play an important role for sporadically observed associations between MS and vitiligo. Future studies of this association should therefore consider stratification by ethnic or genetic factors. 閱讀論文