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Journal Article > Research

Is vitiligo associated with wearing plastic shoes in a podoconiosis endemic region of Ethiopia?

Enbiale W, Abebe K, Debru B, Griensven JV, Takarinda KC, Manzi M, Zachariah R
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Abstract
INTRODUCTION
Endemic non-filarial elephantiasis also known as podoconiosis often affects bare footed farmers and is endemic in Ethiopia. The disease is prevented by wearing shoes. We recently observed several patients presenting to a dermatology clinic with skin depigmentation after wearing plastic shoes (“shoe-contact vitiligo”) which may deter shoe-wearing. We report on their sociodemographic and clinical characteristics.

METHODOLOGY
This is a retrospective study of 17 months at tertiary level Hospital in Ethiopia. Patient data was retrieved from medical record department. We compared sociodemographic and clinical characteristics of patients presenting with idiopathic and shoe-contact vitiligo. Data was presented descriptively.

RESULTS
Of 460 vitiligo cases, 190 (41%) were shoe-contact vitiligo and the rest, idiopathic. The former was more common in females (Odds Ratio, OR = 2.5, P < 0.001) and those in rural areas (OR = 4.8, P < 0.001). Fifty-five percent with shoe-contact vitiligo had itching and/or burning sensation, compared to just 2% with idiopathic vitiligo (P < 0.001) and some had ulcerations (8%). Idiopathic vitiligo had no such findings. Skin discoloration occurred within three weeks (on average) after wearing plastic shoes, 91% of lesions were symmetrical and involved areas of the feet covered with plastic shoes. Symmetric lesions were observed in only 11% of idiopathic vitiligo (OR = 81, P < 0.001).

CONCLUSIONS
Shoe-contact vitiligo was significantly associated with wearing cheap plastic shoes. The exact chemical culprit(s) needs to be identified. This will allow introducing quality control regulations and rigorous monitoring of shoe production sites.
Countries
Ethiopia
Subject Area
non-communicable diseaseneglected tropical diseases
DOI
10.3855/jidc.11705
Published Date
29-Jun-2020
PubMed ID
32614792
Languages
English
Journal
Journal of Infection in Developing Countries
Volume / Issue / Pages
Volume 14, Issue 06.1, Pages 22S-27S
Issue Date
30-Jun-2020
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