Vitiligo is a skin disease of still unclear, multifactorial aetiology. Numerous autoimmunological disturbances observed in vitiligo may be suggestive of a systemic nature of the disease. Since the research into immunological and metabolic abnormalities gives evidence that they may also be present in vitiligo, it seems essential that any disturbances or abnormalities should also be searched for in the patients affected with the condition. Metabolic changes which take place in both the liver and spleen are also worth the interest. Aim & Scope: The aim of the study was to assess the liver and spleen function parameters in the children hospitalized in Department of Dermatology Medical University of Lublin. Material and Methods: The study included 34 vitiligo patients and 35 healthy individuals, aged 7-15 years old. We examined those children who had the active phase of vitiligo, in which exacerbation of skin lesions had a history of 6 months. Liver and spleen ultrasound examination included their size and parenchyma assesment. In order to assess the liver and spleen functioning the following accessory examinations were performed: blood test, transaminases, electrophoresis of proteins, lipid profile, autoantibodies, HCV antibodies. Results: The values of the liver size were not significantly different between the study and control groups. The ultrasonografic pictures of the spleen did not revealed any abnormalities in the size and structure of the organ. The concentration of HDL-cholesterol was significantly lower whereas the concentration of LDL-cholesterol was significantly higher in vitiligo patient in comparison with the healthy group. The value of the LDL/HDL ratio was significantly higher in vitiligo patients. Comments: • Performed investigations are indicative of lipid disturbances in children affected with vitiligo. • However, the ultrasound examination did not reveal any abnormalities with reference to the size and structure of both the liver and spleen. Neither did biochemical investigations reveal any disfunctions of the liver and spleen. • Since there were no structural and functional abnormalities in the liver and spleen it seems plausible that lipid disturbances in vitiligo may result from genetic defect or some auto-cytotoxic events taking part in the condition pathogenesis. • The nature of the conducted research is preliminary and it requires further long-term studies, which would include a wider variety of studied subjects as well as more numerous groups. - Disclaimer- This PPT is loaded as student material "as is", from the VRF Vitiligo Master Class Barcelona November 2011; VRF does not endorse or otherwise approve it.

1. Hepato-splenic abnormalities in vitiligo - do they exist? 1 Joanna Bartosińska, 1 Aldona Pietrzak, 2 Ewa Dybiec, 1 Grażyna Chodorowska 1 Department of Dermatology, Venereology and Paediatric Dermatology Medical University of Lublin, Poland 2 Department of Paediatric Radiology Medical University of Lublin, Poland

11. Parameter Group Min Max M SD p Age (years) V 7 15 10.9 2.0 0.447 C 7 15 10.5 2.3 Height (cm) V 115 170 141.6 13.4 0.717 C 110 173 143.0 17.0 Weight (kg) V 19 50 34.6 8.2 0.299 C 19 63 37.2 12.5 BMI (kg/m 2 ) V 13.2 23.6 17.0 2.1 0.302 C 13.4 25.0 17.6 2.8

13. Total skin involvement

16. Liver (differences statistically insignificant)

17. Spleen (differences statistically insignificant)

19. Blood test (differences statistically insignificant)

22. The structure of albumin and globulins (differences statistically insignificant)

24. Triglyceride Phospholipids

25. Vitiligo Control LDL/HDL