Published: 2017-10-25

Assessment of quality of life in Indian patients with vitiligo, an observational study

Vedang D. Trivedi, Devang A. Rana, Kandarp K. Thakkar, Supriya D. Malhotra


Background: Vitiligo is the most common hypopigmentary disorder. In India, the incidence of vitiligo is 0.25-2.5%. It considerably influences the patient’s quality‑of‑life (QoL) and psychological well‑being.

Methods: A prospective, observational study was conducted from April 2016 to September 2016 in dermatology outpatient department. Patients clinical characteristic were noted and Quality of life was assessed by using Vitiligo Quality of Life Questionnaires [VQLQ]. During item development, none of the questions were changed according to the results of cognitive and understand ability testing. The scale consisted of 25 questions. The answer to each question was scored as ‘never = 1’, ‘sometimes = 2’, ‘often = 3’ and ‘all the time = 4’, so the total score ranged between 25 and 100. Higher scores represented more severely impaired quality of life.

Results: We enrolled 78 Vitiligo patients who were attending dermatology department for phototherapy. Out of them 53 were female. Mean age was 37.12±12.270. Most common age group was 31-40 years. Mean VLQL score 40.92±6.081. Patients were divided based on VQLQ score in Moderate (50-75) and Low score group (25-50). Vitiligo patients presented with symptoms of pain, irritation and itching (P<0.0001). Vitiligo patients when assessed for feeling domain were significantly embarrassed for their overall look and appearance. (P < 0.0001). When Personal relationship domain was analysed physical contact was a major concern (P <0.002). Patients suffering from Vitiligo were significantly worried about spread of vitiligo and occurrence of cancer (P<0.0001). Therapy for Vitiligo was time consuming time and was a work place challenge for the patients (P <0.0001). The reliability of VQLQ in our study was Cronbach’s α coefficient was 0.876.

Conclusions: QoL impairment was relatively high in vitiligo patients. Medical intervention and counselling should focus to improve feelings, personal relationship, anxiety, school/work, leisure and symptom domains.


Quality of life, Vitiligo, VQLQ

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Yaghoobi R, Omidian M, Vitiligo BN. a review of the published work. J Dermatol. 2011;38:419-31.

Mattoo SK, Handa S, Kaur I, Gupta N, Malhotra R. Psychiatric morbidity in vitiligo: prevalence and correlates in India. J Eur Acad Dermatol Venereol. 2002;16:573-8.

Tarlé RG, Nascimento LM, Mira MT, Castro CC. Vitiligo -part 1. An Bras Dermatol. 2014;89:461-70.

Finlay AY. Quality of life indices. Indian J Dermatol Venereol Leprol. 2004;70:143-8.

Ginsburg IH. The psychological impact of skin diseases: An overview. Clin 1996, 14:473-484.

Cotterill JA and Cunliffe WJ: Suicide in dermatological patients. Br J Dermatol. 1997;137(2):246-50.

Gupta V, Sreenivas V, Mehta M, Khaitan BK, Ramam M. Measurement properties of the Vitiligo Impact Scale‐22 (VIS‐22), a vitiligo‐specific quality‐of‐life instrument. British Journal of Dermatology. 2014 Nov 1;171(5):1084-90.

Krishna GS, Ramam M, Mehta M, Sreenivas V, Sharma VK, Khandpur S. Vitiligo impact scale: An instrument to assess the psychosocial burden of vitiligo. Indian Journal of Dermatology, Venereology, and Leprology. 2013 Mar 1;79(2):205.

Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI) -a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;3:210-6.

Anderson RT, Rajagopalan R. Development and validation of a quality of life instrument for cutaneous diseases. J Am Acad Dermatol. 1997;37(1):41-50.

Şenol A, Yücelten AD, Ay P. Development of a Quality of Life Scale for Vitiligo. Dermatology 2013;226:185-90.

Hedayat K, Karbakhsh M, Goodarz A, Fakour Y. Quality of life in patients with vitiligo: a cross-sectional study based on Vitiligo Quality of Life index (Viti QoL) Health and Quality of Life Outcomes. 2016;14:86.

Sarin RC, Kumar AJ. A clinical study of vitiligo. Indian J Dermatol Venereal Leprol. 1977;43:311-4.

Howitz J, Brodhagen H, Schwartz M, Thomsen K. Prevalence of vitiligo. Arch Dermatol. 1977;113:47-52.

Bar S, Feiwel M, Chanarin I. Vitiligo and its aetiological relationship to organ specific auto-immune disease. Br J Dermatol. 1969;81:83.

Martis J, Bhat R, Nandakishore B, Shetty JN. A clinical study of vitiligo. Indian J Dermatol Venereol Leprol. 2002;68:92-3.

DeLisa F, Rose NR. Women and Autoimmune Diseases, Emerging Infectious Diseases. 2004;10(11):2005-11.

Singh S, Twara T, Singh OP. Psychosocial Aspects of Vitiligo. Br J Med Health Res. 2016;3(2):1-10.

Porter J, Beuf AH, Nordlund JJ, Lerner AB. Psychological reaction to chronic skin disorders: a study of patients with vitiligo. Gen Hosp Psychiatry. 1979;1:73-7.

Parsad D, Dogra S, Kanwar AJ. Quality of life in patients with vitiligo. Health Qual Life Outcomes. 2003;1:58.

Porter JR, Beuf AH, Lerner AB, Nordlund JJ. The effect of vitiligo on sexual relationships. J Am Acad Dermatol. 1990;22:221-2.

Mechri A, Amri M, Douarika AA, Ali Hichem BH, Zouari B, Zili J. Psychiatric morbidity and quality of life in vitiligo: a case controlled study [in French]. Tunis Med. 2006;84(10):632-5.

Ongenae K, Van Geel N, De Schepper S, Naeyaert JM. Effect of vitiligo on self reported health-related quality of life. Br J Dermatol. 2005;152(6):1165-72.

Porter J, Beuf A, Nordlund JJ, Lerner AB. Personal responses of patients to vitiligo: The importance of the patient-physician interaction. Arch Dermatol. 1978;114:1384-5.

Porter J, Beuf AH, Nordlund JJ, Lerner AB. Psychological reaction to chronic skin disorders: A study of patients with vitiligo. Gen Hosp Psychiatry. 1979;1:73-7.

Porter J, Beuf AH, Lerner A, Nordlund J. Response to cosmetic disfi gurement: Patients with vitiligo. Cutis. 1987;39:493-4.

Belhadjali H, Amri M, Mecheri A, Doarika A, Khorchani H, Youssef M, et al. Vitiligo and quality of life: A case-control study. Ann Dermatol Venereol. 2007;134:233-6.

Linthorst Homan MW, Spuls PI, de Korte J, Bos JD, Sprangers MA, van der Veen JP. The burden of vitiligo: Patient characteristics associated with quality of life. J Am Acad Dermatol. 2009;61:411-20.

Papadopoulos L, Bor R, Legg C. Coping with the disfiguring effects of vitiligo: A preliminary investigation into the effects of cognitive-behavior therapy. Br J Med Psychol. 1999;72:385-96.

Thompson AR, Kent G, Smith JA. Living with vitiligo: Dealing with difference. Br J Health Psychol. 2002;7:213-25.