Study finds 40% of vitiligo patients in US may not be diagnosed

Vitiligo prevalence is between 0.76% and 1.11% of the U.S. population, with around 40% of those with the condition being undiagnosed, according to a study.

“Worldwide prevalence estimates of vitiligo vary widely with prevalence estimates ranging from 0.004% to 2.28%,” Kavita Gandhi, MS, BSPharm, and colleagues wrote.

Past studies have found a wide variation in vitiligo prevalence in the U.S.; however, most are outdated, did not include those with undiagnosed vitiligo or sampled from specific groups, the authors added.

A population-based, cross-sectional, online survey was conducted between December 2019 and March 2020. Of 322,240 people asked to participate, responses were obtained from 60,524 (18.8%). Of these, 40,888 (mean age, 44.9 years; standard deviation, 17.4 years; 56.7% women; 74.4% white) were eligible for the study.

Self-reported vitiligo was 1.38% (95% CI, 0.54%-0.69%) with 0.77% (95% CI, 0.68%-0.85%) being diagnosed and 0.61% (95% CI, 0.54%-0.69%) being undiagnosed.

Those who reported having vitiligo, either diagnosed or undiagnosed, were asked to upload photographs of their lesions and to download a teledermatology app. Board-certified dermatologists then evaluated the images to determine if vitiligo was present.

Clinician-adjudicated vitiligo prevalence was 0.76% (0.76%-1.11%) with 0.46% (0.46%-0.61%) being diagnosed and 0.29% (0.29%-0.5%) being undiagnosed, based on 113 images evaluated.

Non-segmented vitiligo prevalence was 0.77% (95% CI, 0.68%-0.85%) and segmental vitiligo prevalence was 0.61% (95% CI, 0.53%-0.69%).

“The distinction between segmental and nonsegmental vitiligo is of prime importance for both patients and physicians when reporting on the prevalence of vitiligo,” the authors wrote. “Indeed, patients are usually concerned by the spreading of the disease and its unpredictable course, which is the hallmark of nonsegmental vitiligo.”