Evaluation of the Dermatological Life Quality Index, sexual dysfunction and other psychiatric diseases in patients diagnosed with vitiligo with and without genital involvement

Abstract

Background. Because skin lesions affect self-image, vitiligo affects an individual's emotional and psychological well-being, sexual life and relationships with other people. The literature contains a limited number of studies regarding the localization of vitiligo with respect to its effect on certain variables. Aim. To investigate the effects of the presence or absence of genital involvement in vitiligo on sexual dysfunction, dermatological quality of life (QoL), and susceptibility to other psychiatric disorders such as anxiety and depression. Methods. In total, 90 patients who were admitted to the dermatology outpatient clinic of a tertiary university hospital; the patients included 30 patients with vitiligo with genital involvement, 30 patients with vitiligo without genital involvement and 30 controls (HCs). All groups were evaluated with the Dermatological Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HAD), Arizona Sexual Experience Scale (ASEX) and Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Results. The HC groups exhibited lower total scores on the DLQI, HAD total score, ASEX and GRISS compared with the vitiligo groups (P < 0.05). No statistically significant difference was found between the vitiligo group with genital involvement and the vitiligo group without genital involvement in terms of DLQI, and total scores for HAD, ASEX and GRISS (P > 0.05). Conclusion.The presence or absence of genital involvement in vitiligo did not have dissimilar effects on the individual's QoL, or their sexual and psychological state.

Psychosocial Effects of Vitiligo: A Systematic Literature Review

“…Among QoL instruments assessing general health, total and/or component scores were most frequently reported for the adult and child versions of the Dermatology Life Quality Index (DLQI, 53 studies) [ 4 , 13 , 14 , 18 , 19 , 22 , 25 , 33 , 35 – 38 , 45 , 64 , 65 , 67 – 70 , 74 , 77 , 81 – 83 , 87 , 89 , 90 , 92 , 93 , 96 , 99 , 100 , 102 , 104 , 112 , 115 , 119 , 120 , 122 , 123 , 140 , 143 , 144 , 146 , 148 , 151 , 156 , 161 , 162 , 164 – 166 , 168 ], Children’s DLQI (seven studies) [ 24 , 67 , 73 , 101 , 103 , 110 , 152 ], 36-Item Short Form Health Survey (SF-36, eight studies) [ 9 , 82 , 83 , 105 – 107 , 161 , 162 ], General Health Questionnaire (eight studies) [ 14 , 30 , 65 , 93 ...…”

“…Compared with controls, psychosocial comorbidities noted to be significantly ( p ≤ 0.05) associated with vitiligo were depression (11 studies) [ 23 , 28 , 33 , 34 , 55 , 63 , 128 , 140 , 143 , 145 , 155 ], anxiety (ten studies) [ 23 , 30 , 33 , 34 , 55 , 63 , 119 , 128 , 140 , 155 ], emotional or behavioral impairment (six studies) [ 9 , 23 , 34 , 128 , 140 , 161 ], adjustment disorder (four studies) [ 15 , 30 , 37 , 128 ], low self-esteem (three studies) [ 57 , 65 , 134 ], relationship and sexual dysfunction (three studies) [ 33 , 155 , 161 ], sleep disturbance (two studies) [ 55 , 117 ], suicidality (one study) [ 128 ], self-consciousness (one study) [ 119 ], embarrassment (one study) [ 145 ], alexithymia (one study) [ 108 ], and alcohol abuse or addiction (one study) [ 128 ]. Five studies reported that depression [ 30 , 84 , 85 , 102 , 164 ] and/or anxiety [ 84 , 164 ] scores measured by Beck Inventory scales were not significantly different in patients with vitiligo vs controls.…”

The Impact of Vitiligo on Patients' Psychological Status and Sexual Function: Cross-Sectional Questionnaire-Based Study

“…Also, Morales-Sánchez et al [23] reported that QOL was worse in vitiligo patients with genital lesions. Recently, Yucel et al [8], using Golombok-Rust-Inventory-of-Sexual-Satisfaction had detected significantly lower sexual satisfaction levels among vitiligo patients in comparison to controls.…”

“…Similarly, Salman et al [17] found that vitiligo patients had higher levels of social anxiety and depression compared with healthy control subjects. Yucel et al [8] reported significantly higher scores in comparison to controls by using four documented scoring inventories to evaluate the psychological and sexual status of vitiligo patients.…”

“…Vitiligo has a major effect on sexual health because of the disfiguring skin lesions which affect self-image, self-esteem [7] an individual's emotional and psychological well-being and relationships with other people [8]. Genital self-image is an emerging aspect of body image relevant to sexual functioning and sexual satisfaction [9].…”