Identification of categories at risk for high quality of life impairment in patients with vitiligo

Summary Background Quality of life (QoL) in patients with vitiligo is strongly impaired. Therefore, it seems inadequate to describe the severity of the disease using only physical indicators. Objectives To investigate the QoL of patients with vitiligo, identifying categories at risk for high impairment, also analysing single questions from a QoL instrument. Methods The Skindex‐29 questionnaire, a QoL dermatology‐specific instrument, was completed by 181 consecutive patients with vitiligo. Answers to the Skindex‐29 items were given on a five‐point scale, from ‘never’ to ‘all the time’. Results The QoL problems more frequently experienced ‘often’ or ‘all the time’ were: worry of the disease getting worse (60%), anger (37%), embarrassment (34%), depression (31%), having social life affected (28%), and shame (28%). The prevalence of patients with probable depression or anxiety, evaluated using the 12‐item General Health Questionnaire, was 39%, and the prevalence of patients with alexithymia, evaluated using the 20‐item Toronto Alexithymia Scale, was 24%. The association of QoL impairment with psychological problems was very strong for all the items, and remained significant also when taking into account simultaneously gender, age, clinical severity, family history, and localization of vitiligo. Conclusions Detailed information on QoL in patients with vitiligo may lead dermatologists to pay particular attention to patient categories at risk for a high QoL impairment.