{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T16:40:45Z","timestamp":1776444045845,"version":"3.51.2"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CMRPG3N1442"],"award-info":[{"award-number":["CMRPG3N1442"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 114-2314-B-182A-102"],"award-info":[{"award-number":["NSTC 114-2314-B-182A-102"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NMRPG4Q0151"],"award-info":[{"award-number":["NMRPG4Q0151"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nonsegmental vitiligo frequently recurs after treatment discontinuation despite successful repigmentation. Identifying patients at higher risk of recurrence\/relapse is essential for guiding long-term management and maintenance strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify phenotypic and autoimmune predictors of recurrence\/relapse in nonsegmental vitiligo, and to establish a clinically relevant risk-stratification framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the Chang Gung Research Database (2015\u20132024). Patients with \u2265 6\u2005months of documented clinical stability and \u2265 1\u2005year of follow-up were included. Time from stability to first recurrence\/relapse was analysed using multivariable Cox proportional hazards models adjusted a priori for age, sex, acral and facial involvement, baseline body surface area category (&amp;lt;\u00a05%, 5\u201310%, &amp;gt; 10%), thyroid disease, other autoimmune diseases, anti-thyroid peroxidase, antinuclear antibody levels and family histories. A joint-exposure model assessed combined acral involvement and thyroid disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 809 patients, 266 (32.9%) developed recurrence\/relapse. Independent predictors included acral involvement [adjusted hazard ratio (aHR) 1.56, 95% confidence interval (CI) 1.20\u20132.03; P &amp;lt; 0.001], thyroid disease (aHR 1.42, 95% CI 1.07\u20131.89; P = 0.015) and other autoimmune comorbidities (aHR 1.73, 95% CI 1.23\u20132.41; P = 0.001). Joint-exposure analysis showed that patients with both acral involvement and thyroid disease had significantly elevated hazard (aHR 2.44, 95% CI 1.64\u20133.59; P &amp;lt; 0.001); whereas each factor alone conferred smaller or nonsignificant effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Acral involvement, thyroid disease and other autoimmune comorbidities are key predictors of recurrence\/relapse in nonsegmental vitiligo. Combined acral and thyroid involvement identifies a particularly high-risk subgroup with approximately 2.5-fold higher hazard. Incorporating these phenotypic and autoimmune risk factors into clinical assessment may support risk-stratified maintenance planning and more individualized long-term monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjd\/ljaf531","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T12:55:19Z","timestamp":1766580919000},"page":"854-861","source":"Crossref","is-referenced-by-count":1,"title":["Recurrence and relapse in nonsegmental vitiligo: phenotypic and autoimmune predictors from a large retrospective cohort"],"prefix":"10.1093","volume":"194","author":[{"given":"Hsin-Yu","family":"Shih","sequence":"first","affiliation":[{"name":"Department of Dermatology, Chang Gung Memorial Hospital , Linkou, Taoyuan ,","place":["Taiwan"]},{"name":"Vitiligo Clinic and Pigment Research Center, Chang Gung Memorial Hospital, Linkou Main Branch , Taoyuan 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Dermatology, Chang Gung Memorial Hospital , Linkou, Taoyuan ,","place":["Taiwan"]},{"name":"Vitiligo Clinic and Pigment Research Center, Chang Gung Memorial Hospital, Linkou Main Branch , Taoyuan ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chau Yee","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Chang Gung Memorial Hospital , Linkou, Taoyuan ,","place":["Taiwan"]},{"name":"Vitiligo Clinic and Pigment Research Center, Chang Gung Memorial Hospital, Linkou Main Branch , Taoyuan ,","place":["Taiwan"]},{"name":"Department of Dermatology and Aesthetic Medicine Center, Jen Ai Hospital , Taichung ,","place":["Taiwan"]},{"name":"College of Medicine, Chang Gung University , Taoyuan 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