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Study | Feb 2013 ONLINE FIRST

Association Between Vitiligo Extent and Distribution and Quality-of-Life Impairment

Jonathan I. Silverberg, MD, PhD, MPH; Nanette B. Silverberg, MD

JAMA Dermatol. 2013;149(2):159-164. doi:10.1001/jamadermatol.2013.927.

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Objective

Objective To determine whether the extent, distribution, and duration of vitiligo are associated with impairment of specific aspects of quality of life.

Design

Design A prospective questionnaire-based study of 1541 adults with vitiligo.

Setting

Setting Online questionnaire.

Main Outcome Measures

Main Outcome Measures Affected body surface area (BSA), distribution and duration of vitiligo, associated symptoms, and quality of life using the Dermatology Life Quality Index (DLQI).

Results

Results Vitiligo had a negative effect on numerous aspects and the total score of the DLQI (mean [SD], 5.9 [5.5]). The DLQI scores in vitiligo were associated with an affected BSA of more than 25% (ordinal logistic regression; adjusted odds ratio, 2.17 [95% CI, 1.71-2.75; P < .001]) and number of body parts affected with vitiligo (P ≤ .009) but not laterality (P = .06) or duration of disease (P ≥ .54). Itching and/or burning skin occurred in a sizable percentage of vitiligo patients (35.1%) and were predicted by an affected BSA of more than 25% (adjusted odds ratio, 1.59 [95% CI, 1.26-2.01; P < .001]). Sexual dysfunction occurred in 18% of patients and was predicted by an affected BSA of more than 25% (adjusted odds ratio, 1.94 [95% CI, 1.44-2.61; P < .001]) and vitiligo lesions in the genital area (1.82 [1.30-2.53; P < .001]).

Conclusions

Conclusions Vitiligo extent is associated with increased quality-of-life impairment, including itching and sexual dysfunction. Moreover, different distributions of vitiligo lesions are associated with impairment of different aspects of quality of life.

Trial Registration

Trial Registration clinicaltrials.gov Identifier: NCT01401374

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Figure. Association between the site of vitiligo lesions and specific quality-of-life impairment. Ordinal logistic regression models were constructed with the total Dermatology Life Quality Index (DLQI) score categorized into 3 levels (0-5, no effect or small effect; 6-10, moderate effect; and >10, very or extremely large effect) (A) and with self-consciousness (B) and sexual dysfunction (C) divided into 4 responses (not relevant/not at all, a little, a lot, and very much) as the dependent (outcome) variables. The independent (explanatory) variables were sites of vitiligo lesions, including the face, chest, abdomen, back, arms, hands, legs, feet, and genitals. Data are presented as the percentage of patients with a DLQI score of at least 6 (A), a lot or very much self-consciousness about their vitiligo (B), and a little, a lot, or very much sexual dysfunction (C) among patients who reported vitiligo lesions at the respective site on the diagram. In addition, odds ratios (ORs) (with parenthetical 95% confidence intervals) and P values are given.

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Silverberg JI, Silverberg NB. Association Between Vitiligo Extent and Distribution and Quality-of-Life Impairment. JAMA Dermatol. 2013;149(2):159-164. doi:10.1001/jamadermatol.2013.927.

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