Association between vitiligo extent and distribution and quality-of-life impairment.

OBJECTIVE To determine whether the extent, distribution, and duration of vitiligo are associated with impairment of specific aspects of quality of life. DESIGN A prospective questionnaire-based study of 1541 adults with vitiligo. SETTING Online questionnaire. 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 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 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 clinicaltrials.gov Identifier: NCT01401374