A study of potential risk factors of Shvitra (vitiligo): a case-control pilot study

Abstract

Prevalence of vitiligo in India varies from 0.6% to 1.13% with a high prevalence of up to 8.8% in Gujarat and Rajasthan. It is a major skin disease in public health domain globally. There are many theories behind pathogenesis of vitiligo but autoimmunity is considered as the most crucial trigger, however exposure factors and their association with development of diseases as risk factor largely remain unknown. This study is conducted to assess the role of etiological factors mentioned in Ayurveda literature as risk factor in manifestation of Shvitra (vitiligo). The present study is a case-control study where 80 cases (vitiligo) and 80 controls (healthy) were selected, examined and interrogated for assessment of exposure of viruddha ahara through a validated questionnaire and their blood samples were investigated. Total 93 exposure factors were assessed, of which 47 were found with significant odds ratio in univariate analysis. In subgroup multivariate analysis, 2 of 15 domains assessed showed significant odds namely Vega dharana (OR: 35.4, 95% CI: 1.54-827.0) and Papa karma (OR: 15.78, 95% CI: 1.25- 199.5). Shvitra severity score (SSS) is found positively correlated (r=0.62, p<0.01) with Hs-CRP and also with total viruddha ahara score (r=0.96, p<0.01). This case-control analytical study provides evidence that vega-dharana and Papakarma are the major determinants of Shvitra as described by Acharya Charak. Future prospective studies with larger sample size are warranted to validate this finding and develop preventive and treatment strategies for broader application.