Vitiligo Linked to Elevated Risk of Herpes Zoster: Cohort Study

KEY TAKEAWAYS

• Vitiligo patients had a 53% higher risk of herpes zoster than matched controls in a Taiwanese cohort.

• Systemic therapies like cyclosporine, methotrexate, and corticosteroids further increased HZ risk, according to study data.

• Phototherapy was not assocaited with elevated risk. 

A new cohort study from Taiwan indicated vitiligo is independently associated with a heightened risk of herpes zoster (HZ), with systemic immunosuppressive therapies compounding the risk further.

Using data from Taiwan's Longitudinal Health Insurance Database (2010–2022), researchers identified patients with vitiligo and matched them (1:4) with non-vitiligo controls based on age, gender, index date, and comorbidities through propensity score matching. The final cohort included 79,910 individuals.

Over the study period, the incidence of herpes zoster was 7.78% in the vitiligo group vs 2.72% in matched controls (P < 0.001). After adjustment for confounding variables, vitiligo was associated with a 53% increased risk of HZ (adjusted HR = 1.532). Subgroup analysis revealed the risk of HZ risk was particularly elevated in female patients and those aged ≥60 years, according to subgroup analysis.

Patients receiving systemic therapy [particularly cyclosporine (aHR: 1.891), methotrexate (aHR =1.981), and systemic corticosteroids (aHR = 1.474)] had the highest vulnerability to herpes zoster. Phototherapy alone was not independently associated with elevated risk.

“These findings underscore vitiligo as an independent risk factor for herpes zoster,” the authors wrote. “Systemic immunosuppressive therapies further augment this risk, highlighting the need for preventive strategies, including HZ vaccination, especially among older or female individuals with vitiligo.”

Source: Lin BS, et al. Japanese Journal of Dermatology. 2026. doi:10.1111/1346-8138.70140