Association between celiac disease and vitiligo: A review of the literature

Abstract

Celiac disease (CD) is an autoimmune intestinal disease caused by the intake of gluten-containing cereals and their products by individuals with genetic susceptibility genes. Vitiligo is a commonly acquired depigmentation of the skin; its clinical manifestation are skin patches caused by localized or generalized melanin deficiency. Both diseases have similar global incidence rates (approximately 1%) and are associated to similar diseases, including autoimmune bullous disease, inflammatory bowel disease, autoimmune thyroiditis, autoimmune gastritis, and type 1 diabetes. The relationship between CD and vitiligo has been reported in several studies, but their conclusions are inconsistent. Further, it has also been reported that a gluten-free diet (GFD) can improve the symptoms of immune-related skin diseases such as vitiligo. In this mini-review, we summarize and review the literature on the relationship between CD and vitiligo, assess the therapeutic significance of GFD for patients with vitiligo, and explore their possible physiopathology. We are hopeful that the information summarized here will assist physicians who treat patients with CD or vitiligo, thereby improving the prognosis.

Keywords: Celiac disease; Gluten-free diet; Vitiligo; Dermatitis herpetiformis

Core Tip: Both celiac disease (CD) and vitiligo are autoimmune-related diseases, and their global incidence rates are similar (approximately 1%). This article reviews recent studies on the relationship between CD and vitiligo, and gluten-free diet (GFD) and vitiligo and explores their possible pathogenesis. An analysis based on existing evidence supports the association between CD and vitiligo. Patients with vitiligo and positive serum gluten markers, or with CD, may benefit from a GFD; it could be a valid option depending on the patient's preference. We hope this review will be useful for future treatment.