Association of Quality of Life and Location of Lesions in Patients With Vitiligo

Abstract

Vitiligo is a chronic depigmenting disorder of multifactorial etiology affecting 0.5% to 1% of the population. The white macules characteristic of vitiligo have been shown to have a profound impact on quality of life (QOL) in affected individuals. 1,2 The goal of this cross-sectional study was to determine the location(s) of vitiligo lesions that has the greatest effect on QOL.Methods | All patients enrolled in the Dallas Vitiligo Registry (DVR) at the University of Texas Southwestern (UTSW) Medical Center from April 2013 to August 2015 were reviewed. The DVR was approved by the UTSW Medical Center institutional review board and all patients gave informed consent. They were not compensated for their participation. A total of 184 patients were examined. It was determined that a total sample size of 184 would provide 80% power with a type 1 error of .05. The location of each affected area of skin was documented and the total body surface area affected as well as the vitiligo area severity index was calculated. Each participant also completed the VitiQoL, a vitiligo-specific QOL instrument. 3 The VitiQoL contains 16 questions divided into 3 domains: participation limitation, stigma, and behavior. Questions in the participation limitation domain include those asking about the patient's ability to perform daily activities and social and leisure activities. Stigma includes questions about embar-

Psychosocial Effects of Vitiligo: A Systematic Literature Review

“…In contrast, the Vitiligo-specific QoL (VitiQoL) instrument has only been reported in eight studies [ 13 , 16 , 29 , 32 , 67 , 80 , 88 , 115 ] using our search parameters; half were published in the past year, of which two were clinical trials. There were no notable regional differences in VitiQoL scores among studies, which were conducted in each of the seven geographic regions, with two in North America.…”

“…Factors that were significantly associated with higher psychosocial (Fig. 3 ) or overall QoL burden were female sex (30 studies) [ 15 , 21 , 25 , 28 , 30 , 45 , 46 , 49 , 51 , 57 , 62 , 66 – 68 , 70 , 88 , 90 , 99 , 104 , 107 , 109 , 112 , 113 , 120 , 123 , 132 , 143 , 146 , 154 , 158 ], lesion location in visible areas (e.g., face, hands [17 studies]) [ 4 , 25 , 35 , 37 , 49 , 62 , 70 , 80 , 89 , 90 , 92 , 101 , 122 , 123 , 138 , 143 , 151 ] or genitals (eight studies) [ 70 , 89 , 97 , 105 , 115 , 122 , 144 , 151 ], younger age (16 studies; particularly those aged <30 years and more so in adolescents) [ 17 , 25 , 30 , 48 , 49 , 62 , 67 , 68 , 70 ,…”

Patients’ perspective on current treatments and demand for novel treatments in vitiligo

“…Another study found that lesions on the genital area were associated with a high burden 11 . Florez‐Pollack et al illustrated that lesions on the hands were even more bothersome compared with the face and neck 15 . We hypothesize that the disease burden and its relation to the location of the various vitiligo lesions could be correlated with the demand for new therapies.…”

Classification of facial vitiligo: A cluster analysis of 473 patients

“…Vitiligo is a common autoimmune depigmentation disorder affecting 0.5%–2% of the population, and it remains a major challenge in dermatology (Alikhan, Felsten, Daly, & Petronic‐Rosic, ). Vitiligo has a substantial negative impact on quality of life in affected patients, especially those with the involvement of the face (Bae et al., ; Florez‐Pollack et al., ). Although the face is known to be the most responsive body part to conventional phototherapy (Nicolaidou, Antoniou, Stratigos, Stefanaki, & Katsambas, ), the treatment of facial vitiligo is not always successful.…”