People with vitiligo are more likely to have other autoimmune disorders than people who don’t have it. About 20% of people with vitiligo also have a different autoimmune disease. This may be due to similarities and overlaps in some genes and environmental factors.
This article discusses the connection between vitiligo and lupus, their symptoms, and treatment options.
NLRP1 Gene
Scientists are still learning a lot about the complex factors that cause vitiligo. They think it probably happens due to a complicated combination of environmental effects and a person’s genes. That refers to individual differences in the DNA you inherit from your parents.
Many of the specific genes thought to increase one’s risk of vitiligo make proteins that are involved in the immune system. One especially important gene is called NLRP1 (nuclear localization leucine-rich-repeat protein 1; also sometimes abbreviated as NALP1).
The protein made by the NLRP1 gene is a key regulator of the immune system. It is especially important in the skin, where it helps start an immune response if an infection is sensed. Certain variations of the NLRP1 gene are much more common in people with certain autoimmune diseases, including:
Vitiligo Lupus Addison’s disease Type 1 diabetes Rheumatoid arthritis Systemic sclerosis
Vitiligo and Lupus
So, having variations in certain genes like NLRP1 might increase your risk of getting vitiligo, lupus, or both. Other unidentified environmental factors might be involved, too, but we are still learning a lot.
We also know that people who have lupus are at higher risk of having other autoimmune diseases as well, such as vitiligo. So if you get one, you are more likely to eventually get the other compared with someone who doesn’t have an autoimmune disorder.
Vitiligo and Other Autoimmune Disorders
Similarly, having vitiligo increases one’s chances of having other autoimmune disorders. This might be because of NLRP1, other genes, or other environmental factors. People who have more severe vitiligo are more likely to have one or more additional autoimmune disorders.
The following are just some of the autoimmune disorders that are common in people with vitiligo:
Hashimoto’s thyroid disease (causing hypothyroidism) Graves’ thyroid disease (causing hyperthyroidism) Pernicious anemia Addison’s disease Rheumatoid arthritis Scleroderma Type 1 diabetes
Additionally, these autoimmune diseases seem to be more common in people with close relatives who have vitiligo.
Treatment
Fortunately, vitiligo itself affects just the skin and shouldn’t interfere too much with your everyday life. However, some people do experience psychological stress or embarrassment from their symptoms.
Currently, treatment options for vitiligo are limited and often don’t work very well. Some options include:
Steroid creams applied to the skin Other creams applied to the skin, such as Protopic (tacrolimus) or Opzelura (ruxolitinib) Steroid drugs (like prednisone) taken by mouth Light therapy
Scientists are actively working to find more effective treatments for the condition.
If you have another autoimmune disease, such as lupus, your potential symptoms may be more serious, and treatment is likely to be much more involved. Many of these people need to take regular oral medications to keep their symptoms in check.
For example, someone with lupus might need to take one or more of the following:
Plaquenil (hydroxychloroquine) Glucocorticoids like prednisone Otrexup (PF), Xatmep, or Trexall (all methotrexate) Imuran (azathioprine) CellCept (mycophenolate; MMF)
If you have more than one autoimmune disease, your clinician will carefully tailor your treatment to address both conditions.
A Word From Verywell
If you are someone with more than one autoimmune disease, you might feel angry and unlucky. Unfortunately, because of the way the immune system works, having one of these conditions does increase your risk of getting another.
It can be challenging, but with good treatment, these conditions are usually manageable. Don’t hesitate to talk to your doctor about all your concerns and discuss any new potential symptoms.
