[Vitiligo in Germany : A claims data analysis on prevalence, comorbidity, and treatment patterns]

Vitiligo is a chronic immune-mediated disease characterized by depigmented skin areas and associated with a wide range of psychological and physical comorbidities. Data on prevalence, comorbidity, and treatment patterns in Germany are currently limited.

In this retrospective analysis of statutory health insurance (SHI) claims data, information from insured individuals (≥ 12 and ≥ 18 years) from 2023 was evaluated. Prevalent cases were identified using the ICD-10-GM code for vitiligo according to M2Q criteria; incident cases were defined by the absence of diagnosis in the previous year. Comorbidities were compared with a matched control cohort. The therapy analysis was conducted for the prevalence cohort and stratified by medical specialty as well as by exclusion of diagnoses with overlapping therapies.

The SHI-adjusted prevalence of vitiligo was 0.14%, with an incidence of 0.03%, both peaking in the 55-64 age group. Of 673 examined ICD-10 diagnoses, 343 (51.0%) occurred significantly more often in vitiligo patients compared to matched controls (odds ratio > 1; p ≤ 0.05), particularly autoimmune diseases such as thyroiditis, alopecia areata, and type 1 diabetes mellitus. In the prevalence cohort, only 22.1% of those affected received any reimbursed treatment. In the subcohort of specialized medical groups and diagnoses without overlapping treatment patterns, 8.2% were treated, of whom around 90% received topical therapy. Systemic glucocorticoids and UV therapies were rarely prescribed.

The analysis illustrates the current care situation for vitiligo in Germany, emphasizes the systemic nature of the disease, and suggests an alarming undertreatment.