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Epidemiological studies indicate that vitiligo is inherited in a multi-factorial pattern. Identical twins with identical DNA have only a 23% concordance in developing vitiligo, suggesting a significant non-genetic component in the disease.

Familial clustering of generalized vitiligo with other autoimmune diseases is compelling evidence for an autoimmune predisposition, a common underlying genetic susceptibility to an immunological aberrancy Among vitiligo patients, 20% report thyroid disease (an 8-fold increase over the general population), particularly hypothyroidism. Similarly, there is an increased frequency in other forms of autoimmune diseases and autoimmune disorders of the endocrine system .