Definition of Severity and Relapse for Vitiligo: An International Consensus Statement

Area of Science:

• Dermatology and Autoimmune Diseases
• Clinical Trial Methodology
• Patient-Reported Outcomes

Background:

• Existing measures for vitiligo severity, such as body surface area, do not fully encompass the disease's clinical and psychosocial impact.
• Lack of international consensus complicates consistent assessment and management of vitiligo severity and relapse.

Purpose of the Study:

• To develop internationally agreed-upon definitions and criteria for vitiligo severity and relapse.
• To establish a comprehensive framework that integrates clinical and patient-reported aspects of vitiligo.

Main Methods:

• A global, mixed-methods consensus study involving literature review, qualitative research, and two rounds of electronic Delphi surveys.
• A final consensus meeting with experts and individuals with vitiligo to finalize criteria.
• A predefined recruitment framework ensured diversity in age, sex, skin phototype, and ethnic background.

Main Results:

• Consensus reached that body surface area measurement is insufficient for assessing vitiligo burden.
• Twelve major criteria for assessing vitiligo severity were recommended, including disease activity, psychosocial effects, and impact on quality of life.
• Minor criteria included factors like darker skin tones, younger age, and impact on education or career.
• Relapse was defined as repigmentation loss in previously treated or spontaneous repigmented areas.

Conclusions:

• Internationally agreed-upon severity criteria for vitiligo have been established.
• The new criteria aim to bridge the gap between physician assessment and patient experience.
• This consensus will improve the consistency and relevance of vitiligo classification in clinical care, research, and regulatory settings.