Background  Most cases of vitiligo are sporadic, but about 10–36% of the patients have positive family history.

Objective  The aim of our study was to describe differences between familial and sporadic cases of vitiligo.

Methods  A total of 186 adult vitiligo patients were examined, in 173 of whom the level of thyroid peroxidase antibodies, gastric parietal cell antibodies (PCA), antinuclear antibodies (ANA), anti-adrenal cortex antibodies and rheumatoid factor in blood was measured. All patients were divided in two groups: the cases with positive family history of vitiligo (51) and the sporadic cases (135).

Results  The risk of onset of the disease up to 20 years of age was higher in the familial group (P = 0.008). Patients in familial group showed more widespread depigmentation compared with sporadic cases [body surface area (BSA) over 10%: P = 0.004; BSA over 50%: P = 0.001]. In familial group, patients had darker skin phototype (P = 0.045) and the disease had started more often as a vulgar vitiligo (P = 0.008). In sporadic vitiligo group, female gender was a risk factor for more widespread depigmentation (BSA over 10%, P = 0.001). Extensive depigmentation was associated with reported triggering factors and mucosal involvement in both groups and with leukotrichia only in familial group. Widespread depigmentation related to the risk of presence of autoantibodies (P = 0.03) in sporadic cases of vitiligo (especially of PCA: P = 0.04 and ANA: P = 0.0002).

Conclusions  In this study, we demonstrated first time that patients with familial vitiligo have a higher risk for vulgar type at the beginning of the disease and female gender increases the risk for more extensive depigmentation in sporadic cases.