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Association between vitiligo extent and distribution and quality-of-life impairment
Jonathan I Silverberg1, Nanette B Silverberg
1Departments of Dermatology, Beth Israel Medical Center and St Luke’s–Roosevelt Hospital Center, New York, NY 10025, USA.
Objective:
To determine whether the extent, distribution, and duration of vitiligo are associated with impairment of specific aspects of quality of life.
Design:
A prospective questionnaire-based study of 1541 adults with vitiligo.
Setting:
Online questionnaire.
Main Outcome Measures:
Affected body surface area (BSA), distribution and duration of vitiligo, associated symptoms, and quality of life using the Dermatology Life Quality Index (DLQI).
Results:
Vitiligo had a negative effect on numerous aspects and the total score of the DLQI (mean [SD], 5.9 [5.5]). The DLQI scores in vitiligo were associated with an affected BSA of more than 25% (ordinal logistic regression; adjusted odds ratio, 2.17 [95% CI, 1.71-2.75; P<.001]) and number of body parts affected with vitiligo (P≤.009) but not laterality (P=.06) or duration of disease (P≥.54). Itching and/or burning skin occurred in a sizable percentage of vitiligo patients (35.1%) and were predicted by an affected BSA of more than 25% (adjusted odds ratio, 1.59 [95% CI, 1.26-2.01; P<.001]). Sexual dysfunction occurred in 18% of patients and was predicted by an affected BSA of more than 25% (adjusted odds ratio, 1.94 [95% CI, 1.44-2.61; P<.001]) and vitiligo lesions in the genital area (1.82 [1.30-2.53; P<.001]).
Conclusions:
Vitiligo extent is associated with increased quality-of-life impairment, including itching and sexual dysfunction. Moreover, different distributions of vitiligo lesions are associated with impairment of different aspects of quality of life.
Trial Registration:
clinicaltrials.gov Identifier: NCT01401374
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