Differences in quality of life recorded for vitiligo, several skin diseases

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Investigators from Taiwan noted differences in quality of life (QoL) in patients with different skin conditions, especially those related to facial discoloration.

In their study, patients with vitiligo were the only group of patients who reported poorer general health compared to the general population. They believed this explained the mismatch between quality of life scores and willingness to pay (KAP) in this group of patients.

Investigators led by Cheng-Che E. Lan, MD, PhD, Kaohsiung Medical University Hospital, noted that previous studies examining the burden of skin disorders associated with facial discoloration generally focused on a single disease.

In the present study, Lan and colleagues quantified and compared the disease burden of different skin disorders associated with facial skin discoloration using the latest tools.

The methods

The single-center cross-sectional study involved consecutive patients aged 20 years or older seeking treatment for facial discoloration.

The recruitment period ran from April 2019 to March 2020 and a total of 211 patients were included in the study.

Several skin disorders were examined in the study, including melasma (58), lentigo (56), post-inflammatory hyperpigmentation (5), vitiligo (51), acne-induced erythema (10 ) and rosacea (31).

The health-related quality of life of all patients was measured by the Taiwanese version of the SF-36 health survey questionnaire and the Dermatology Life Quality Index (DLQI).

The SF-36 Health Survey Questionnaire assessed health quality in 8 domains, including physical function, role limitation related to physical problems, body pain, general health, social functioning, vitality, role limitation related to emotional problems and mental health.

Pre-treatment photographs were taken of all participants and their disease severity was rated using the Investigator’s Global Rating Scale (IGA) which ranged from 0 to 5.

Information regarding monthly income and WTP for complete cure of the condition was collected from each patient.

The results

A main finding of the study, the researchers reported that patients with vitiligo, acne-induced erythema, and rosacea reported significantly worse quality of life than lentigines or melasma patients assessed by the DLQI.

Using the SF-36, rosacea patients were mentally affected more than any other group of patients, as they reported the worst component scores in the study. These scores were significantly worse than those of patients with melasma (rosacea vs melismus = 46.5 vs 52.7, p = 0.007).

When it comes to general health scores, vitiligo patients were the most affected, with the group having the highest percentage of patients willing to pay more than 40% of their monthly income for a full cure.

Although not statistically significant, patients with vitiligo had the lowest overall health score compared to all other disorders presented in the study, with worse scores compared to the general population as well.

Investigators believed this indicated that patients in the vitiligo group viewed their illness as a reflection of poor general health.

Regarding the results presented in the study, the researchers concluded that skin disorders associated with co-morbidities such as hyperpigmentation, depigmentation or erythema negatively impact quality of life.

Of the 6 disorders included in the study, rosacea patients had the worst quality of life in most areas. In their conclusions, the investigators paid particular attention to findings related to vitiligo.

“From the results derived from this study, we propose that patients with vitiligo consider their general health to be affected by the disease and, therefore, are willing to pay more money to cure the disease”, wrote the team.

The study, “Impacts of skin disorders related with facial discoloration on quality of life: Novel insights Explaining discordance between life quality scores and ready to pay,” was published online in the Journal of Cosmetic Dermatology.


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