Beyond depigmentation: A cross-sectional study of 5227 Chinese patients with vitiligo

Vitiligo is a chronic, disfiguring disease associated with autoimmune comorbidities and psychosocial burdens, although comprehensive Chinese population data remain limited. This study systematically characterizes the clinical and psychosocial profiles of treatment-seeking patients with vitiligo, addressing gaps in understanding disease severity, comorbidities, and mental health impacts to guide integrated management approaches. A cross-sectional analysis of 5227 Chinese patients with vitiligo after unsatisfactory conventional therapy was conducted. Among the 5227 patients with vitiligo, nonsegmental vitiligo (88.7%) predominated, with 73.2% in progressive stage. Family history was reported in 13.5%, and comorbidities (primarily thyroid disorders, 10.9%) occurred in 21.2%. Most patients (62%) developed vitiligo before the age of 30 years. All received prior treatments (79% received ≥2 therapies), and 94.2% had visible-area lesions (face/neck/hands), with ∼80% showing complete depigmentation. Severe vitiligo was significantly associated with male sex (adjusted OR [aOR] = 2.17), disease duration >10 years (aOR = 20.56), and nonsegmental subtype (aOR = 12.31). QOL impairment was observed in the following characteristics: female sex (aOR = 1.87), severe vitiligo (aOR = 1.66), depression (aOR = 1.81), low self-esteem (aOR = 2.83), and hopelessness (aOR = 2.59). Chinese patients with vitiligo face multidimensional burdens-chronicity, visible-area depigmentation, comorbidities, and psychological distress-exacerbated by fragmented treatments. Findings underscore the need for integrated management models combining dermatological, psychological, and systemic interventions beyond depigmentation-focused therapies.