Abstract
INTRODUCTION: Factors associated with vitiligo burden in patients with darker skin (Fitzpatrick skin types IV-VI) are not fully understood. This analysis of patients in the global VALIANT study examined the quality of life (QoL) and psychosocial health among patients with vitiligo by skin type. METHODS: Participants from 17 countries were surveyed regarding their clinical characteristics, everyday experiences with vitiligo, impact of vitiligo on daily activities, emotional well-being, and mental health. RESULTS: Of 3541 surveyed patients, 40.8% (n = 1445) had darker skin versus 59.2% (n = 2096) with fairer skin (types I-III). Patients with darker skin had greater median disease extent than those with fairer skin (6.6% vs 2.5%; P < 0.0001). Mean Vitiligo Impact Patient scale scores were higher among patients with darker skin (31.2 vs 24.5; P < 0.0001); daily activities and emotional well-being were significantly more impacted among patients with darker skin. Among individual skin types, patients with types V and VI expressed considerably higher rates of burden versus all other skin types in all assessments. Interestingly, among patients with fairer skin, those with skin type I reported higher rates of burden than those with skin types II and III. CONCLUSION: Patients with darker skin, particularly skin types V and VI, were more impacted in their daily lives, emotional well-being, and mental health than those with fairer skin, suggesting that a disproportionate need for strategies to improve QoL and mental health burden exists among patients with vitiligo who have skin of color.