Quality of life, disease burden and healthcare need of patients with vitiligo

Abstract

Background: With a prevalence of 0.5–2%, vitiligo is one of the most common skin disorders worldwide with loss of pigment. The skin disease has a disfiguring, often stigmatising character and is often associated with psychosocial distress. Objective: To provide an overview of the psychosocial impairment, disease burden and resulting health care needs of patients with vitiligo. Materials and methods: Narrative review based on a literature search in PubMed for the years 1996–2022 on disease burden, quality of life and stigmatization is provided. Results: The search yielded 175 relevant original papers including clinical studies, meta-analyses and systematic reviews (n = 65) for the search period. A large number of studies document that vitiligo is associated with considerable psychosocial stress and relevant losses in quality of life. Problem areas particularly concern stigmatisation, sexual dysfunction, anxiety, reduced self-esteem and problems at work. The observed increased levels of anxiety and depression correlate with the severity and activity of vitiligo. Often, comorbidity also contributes to reduced self-esteem and social isolation. These factors determine a high need for care in a relevant proportion of those affected. Conclusion: Vitiligo is not primarily a cosmetic problem, but a disease requiring treatment according to the World Health Organisation’s definition of health as physical, mental and social well-being. The benefits of treatment options are to be measured by their effects on patient-reported outcomes.