Determination of elevated eosinophil to lymphocyte ratio, eosinophil to neutrophil ratio, eosinophil to monocyte ratio and its association with severe vitiligo: A retrospective cohort study

Abstract

Background Hematological markers such as eosinophil-to-lymphocyte (ELR), eosinophil-to-neutrophil (ENR), and eosinophil-to-monocyte (EMR) ratios may be used in the assessment of skin diseases. However, the relationship with vitiligo remains unclear. Objectives We investigated ELR, ENR, and EMR in vitiligo patients and the association with severe vitiligo. Methods This study included patients of all ages diagnosed with vitiligo between 2005–2020. ELR, EMR, and ENR were calculated from complete blood counts within 30 days of the first recorded vitiligo diagnosis and 12–18 months before the vitiligo diagnosis. We evaluated the associations between ELR, ENR, and EMR and vitiligo. Results 9,826 vitiligo patients (8,398 adults and 1,428 children) and 8,951 age and sex-matched controls were included in this study. We found that ELR, EMR, and ENR were higher in children than in adults. Patients with vitiligo had higher ENR and EMR than their matched controls. Patients with severe vitiligo had higher ELR, ENR, and EMR compared to patients with mild vitiligo. Patients with increased ENR and EMR 12–18 months before the vitiligo diagnosis had a higher chance of having severe vitiligo (ENR: OR = 7.40, p<0.001, EMR: OR = 3.17, p<0.001). Conclusion ELR, ENR, and EMR may be used in the assessment and prognosis of vitiligo, especially in severe cases.