Prevalence of Vitiligo Among Adults in the United States

Abstract

IMPORTANCEVitiligo can have profound effects on patients and is often associated with other autoimmune comorbid conditions. It is important to understand the current prevalence of vitiligo, including diagnosed, undiagnosed, and subtypes (nonsegmental and segmental).OBJECTIVE To estimate the point prevalence of vitiligo in the US. DESIGN, SETTING, AND PARTICIPANTSFor this population-based study of adults in the US, a cross-sectional online survey was administered between December 2019 and March 2020 to obtain participant self-reported vitiligo status. A representative sample of the US adult general population, aged 18 to 85 years, was recruited using a stratified proportional, sampling design from general population research panels. Additionally, 3 expert dermatologists adjudicated participants' self-reported vitiligo diagnosis by reviewing photographs uploaded by the participants using a teledermatology app designed and tested specifically for this study. MAIN OUTCOMES AND MEASURESThe main outcomes were the point prevalence estimates of overall vitiligo, as well as diagnosed, undiagnosed, nonsegmental, and segmental vitiligo. RESULTS Among the 40 888 eligible adult participants, the mean (SD) age was 44.9 (17.4) years, 23 170 (56.7%) were female, 30 428 (74.4%) were White, and 4225 (10.3%) were of Hispanic, Latino, or Spanish origin. Self-reported vitiligo prevalence was 1.38% (95% CI, 1.26%-1.49%), with 0.77% (95% CI, 0.68%-0.85%) for diagnosed and 0.61% (95% CI, 0.54%-0.69%) for undiagnosed. Based on expert dermatologist review of 113 photographs of participants with self-reported vitiligo, clinician-adjudicated vitiligo prevalence (sensitivity bounds) was 0.76% (0.76%-1.11%), with 0.46% (0.46%-0.61%) for diagnosed and 0.29% (0.29%-0.50%) for undiagnosed. Self-reported nonsegmental vitiligo prevalence was 0.77% (95% CI, 0.68%-0.85%), with 0.48% (95% CI, 0.41%-0.55%) for diagnosed and 0.29% (95% CI, 0.23%-0.34%) for undiagnosed. Clinician-adjudicated nonsegmental vitiligo prevalence (sensitivity bounds) was 0.58% (0.57%-0.84%), with 0.37% (0.37%-0.49%) for diagnosed and 0.21% (0.20%-0.36%) for undiagnosed. Self-reported segmental vitiligo prevalence was 0.61% (95% CI, 0.53%-0.69%), with 0.28% (95% CI, 0.23%-0.33%) for diagnosed and 0.33% (95% CI, 0.27%-0.38%) for undiagnosed. Clinician-adjudicated segmental vitiligo prevalence (sensitivity bounds) was 0.18% (0.18%-0.27%), with 0.09% (0.09%-0.12%) for diagnosed and 0.08% (0.08%-0.15%) for undiagnosed. CONCLUSIONS AND RELEVANCEResults of this survey study demonstrated that the current US population-based prevalence estimate of overall (diagnosed and undiagnosed combined) vitiligo in adults is between 0.76% (1.9 million cases in 2020) and 1.11% (2.8 million cases in 2020). Additionally, this study suggests that approximately 40% of adult vitiligo in the US may be undiagnosed. Future studies should be performed to confirm these findings.

Impact of nonsegmental vitiligo on patients’ health-related quality of life in the United States

“…This study reports the HRQoL impact of vitiligo and its association with characteristics of patients with NSV as part of a broader epidemiological study of vitiligo 8 and supports treatment approaches that include HRQoL assessments during clinic visits for patients with vitiligo to better assess disease impact and manage this disease.…”

“…This was a cross‐sectional, online, population‐based survey in which we recruited individuals from US general population research panels (30 December 2019–11 March 2020) using a stratified proportional sampling design. Participants answered questions on demographics and clinical characteristics and vitiligo screening questions, with a previous publication describing prevalence data from the same cohort 8 . Vitiligo severity was determined with the Self‐Assessment Vitiligo Extent Score (SA‐VES) by measuring body surface area (BSA) involvement in participants reporting bilateral vitiligo and assessing facial and hand involvement.…”

Reliability analysis of a novel measurement system for quantifying human skin color

“…Vitiligo is an autoimmune disorder causing patchy loss of skin pigmentation occurring in 0.76%–1.11% of adults. 12 Several assessment tools incorporating key determinants of skin lesions have been developed to improve vitiligo disorder treatment. 13 For example, the Vitiligo Extent Tensity Index score mainly depends on cutaneous and hair pigmentation and the proportion of pigmented and depigmented areas in the total body surface.…”

Comparison of NB‐UVB combination therapy regimens for vitiligo: A systematic review and network meta‐analysis

“…Vitiligo is a common acquired depigmentation disorder skin disease, which characterized by the destruction of melanocytes in the epidermal, mucosa, and other tissues, resulting in delimited white macules 1,2 . The etiology of vitiligo remains unknown.…”