Clinical heterogeneity in vitiligo: Identification of clinical markers based patient clusters

Vitiligo (non-segmental) is a chronic autoimmune skin disease leading to white patches. Although vitiligo has been delineated previously, the endophenotypes of the disease are still to be defined.

The aim of this study was to investigate, without prior hypotheses, whether different clinical phenotypes of vitiligo could be identified and differ based on their demographic and clinical characteristics.

This retrospective, non-interventional, single-centre study included patients with vitiligo. Demographic and clinical characteristics of vitiligo were recorded. Hierarchical cluster analysis was then performed.

A total of 399 patients were included. The cluster analysis classified the patients into five clusters as follows: (1) 'highly active patients' with elevated frequency of disease activity signs, receiving combinatorial topical and systemic therapy; (2) mild vitiligo patients with younger patients, low surface area involved and absence of signs of disease activity; (3) extensive vitiligo patients, with older patients and the largest surface area involved; (4) and (5) mild or moderate to severe disease, with localization of the lesions on site of chronic skin friction (type 2A koebner phenomenon).

Patients with vitiligo can be classified into five phenotypes, with two defining the highly active and extensive patients.