Sulfasalazine-induced generalized vitiligo in a patient with dermatitis herpetiformis and celiac disease

Dermatol Ther. 2019 Sep;32(5):e13007. doi: 10.1111/dth.13007. Epub 2019 Jul 8.

Abstract

Vitiligo is an acquired idiopathic pigmentary skin disorder characterized by the development of white macules and patches due to the loss of functioning melanocytes. In this report, we describe a case of a patient with a longstanding history of dermatitis herpetiformis (DH) and celiac disease that developed rapidly progressing, biopsy-confirmed generalized vitiligo after 11 months of treatment with anti-inflammatory medication sulfasalazine, prescribed for the patient's DH. To the best of our knowledge, this is the first case report which has demonstrated the possible biochemical pathways, triggered by sulfasalazine, in the development of vitiligo.

Keywords: celiac disease; dermatitis herpetiformis; generalized vitiligo; sulfasalazine.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Biopsy
  • Celiac Disease / complications
  • Celiac Disease / diagnosis
  • Celiac Disease / drug therapy*
  • Dermatitis Herpetiformis / complications
  • Dermatitis Herpetiformis / diagnosis
  • Dermatitis Herpetiformis / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Skin / pathology*
  • Sulfasalazine / adverse effects*
  • Sulfasalazine / therapeutic use
  • Vitiligo / chemically induced*
  • Vitiligo / diagnosis

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Sulfasalazine