Exploring How Healthcare Professionals Diagnose and Manage Vitiligo: Global VALIANT Study Findings and Recommendations

Vitiligo is a chronic autoimmune disease characterized by progressive skin depigmentation. Many patients experience delayed diagnosis, which can prolong associated psychosocial burden. This study explored vitiligo diagnostic and management approaches among healthcare professionals (HCPs) who regularly treat patients with vitiligo.

The cross-sectional, multinational Vitiligo and Life Impact Among International Communities (VALIANT) survey recruited HCPs practicing in dermatology, primary medicine, or internal medicine and assessed how they diagnose and treat vitiligo.

Among 1203 HCPs who completed the survey, most were dermatologists (91.4% versus primary care physicians [PCPs], 8.6%). In total, 62.3% (749/1203) of HCPs self-reported being vitiligo specialists and rarely or never made referrals; most nonspecialist HCPs (82.2% [373/454]) also attempted treating patients before referring them to vitiligo specialists. Although most HCPs diagnosed vitiligo by examining lesions (74.1% [892/1203]), less than half used Wood's lamp (42.3% [509/1203]) to support examination. HCPs most commonly prescribed topical therapies (91.4% [1099/1203]); light, laser, or phototherapy (65.7% [790/1203]); and oral medications (53.8% [647/1203]). Among HCPs who reported prescribing topical, light, and oral treatments at least sometimes, 14.4%, 9.6%, and 4.4%, respectively, waited > 6 months to determine treatment outcome, whereas 45.5%, 49.8%, and 69.9% waited ≤ 3 months. More than half of HCPs (60.8% [731/1203]) also reported advising patients to take a drug holiday from vitiligo treatment, most commonly due to lack of treatment response (32.5% [316/972]).

Findings underscore the need for continued education of HCPs regarding vitiligo management, supplemented with rapid referral or consultation with vitiligo specialists for optimal care. The authors highlight that timely diagnosis and treatment are essential in vitiligo management; Wood's lamp may be a useful tool to support vitiligo diagnosis and monitoring, although its value may vary by patient skin type. Furthermore, because repigmentation is a lengthy process, prolonged treatment for at least 6 months is essential to support optimal outcomes.