The lifetime risk and impact of vitiligo across sociodemographic groups: a UK population-based cohort study
- PMID: 39018020
- DOI: 10.1093/bjd/ljae282
The lifetime risk and impact of vitiligo across sociodemographic groups: a UK population-based cohort study
Abstract
Background: Vitiligo is an autoimmune skin disorder characterized by depigmented patches of skin, which can have significant psychological impacts.
Objectives: To estimate the lifetime incidence of vitiligo, overall, by ethnicity and across other sociodemographic subgroups, and to investigate the impacts of vitiligo on mental health, work and healthcare utilization.
Methods: Incident cases of vitiligo were identified in the Optimum Patient Care Database of primary care records in the UK between 1 January 2004 and 31 December 2020. The lifetime incidence of vitiligo was estimated at age 80 years using modified time-to-event models with age as the timescale, overall and stratified by ethnicity, sex and deprivation. Depression, anxiety, sleep disturbance, healthcare utilization and work-related outcomes were assessed in the 2 years after vitiligo diagnosis and compared with matched controls without vitiligo. The study protocol for this retrospective observational study was registered with ClinicalTrials.gov (NCT06097494).
Results: In total, 9460 adults and children were newly diagnosed with vitiligo during the study period. The overall cumulative lifetime incidence was 0.92% at 80 years of age [95% confidence interval (CI) 0.90-0.94]. Cumulative incidence was similar in female (0.94%, 95% CI 0.92-0.97) and male patients (0.89%, 95% CI 0.86-0.92). There were substantial differences in lifetime incidence across ethnic groups, listed by Office for National Statistics criteria [Asian 3.58% (95% CI 3.38-3.78); Black 2.18% (95% CI 1.85-2.50); Mixed/multiple 2.03% (95% CI 1.58-2.47); Other 1.05% (95% CI 0.94-1.17); and White 0.73% (95% CI 0.71-0.76)]. Compared with matched controls, people with vitiligo had an increased risk of depression [adjusted odds ratio (aOR) 1.08, 95% CI 1.01-1.15]; anxiety (aOR 1.19, 95% CI 1.09-1.30); depression or anxiety (aOR 1.10, 95% CI 1.03-1.17); and sleep disturbance [adjusted hazard ratio (aHR) 1.15, 95% CI 1.02-1.31]. People with vitiligo also had a greater number of primary care encounters (adjusted incidence rate ratio 1.29, 95% CI 1.26-1.32) and a greater risk of time off work (aHR 1.15, 95% CI 1.06-1.24). There was little evidence of disparities in vitiligo-related impacts across ethnic subgroups.
Conclusions: Clinicians should be aware of the markedly increased incidence of vitiligo in people belonging to Asian, Black, Mixed/multiple and Other groups. The negative impact of vitiligo on mental health, work and healthcare utilization highlights the importance of monitoring people with vitiligo to identify those who need additional support.
Plain language summary
Vitiligo is the most common pigmentary skin disorder that causes white patches of skin on the body. The condition can develop at any age. Most often, it starts in childhood. Living with vitiligo can be stressful. People with vitiligo can be at an increased risk of experiencing mental health conditions. We investigated how the risk and impact of vitiligo varies across different groups of people. We used anonymized medical records from general practices across the UK from 2004 to the end of 2020. We looked at how many people developed vitiligo. We also looked at how old people were when they were diagnosed. We compared the risk of developing vitiligo between female and male patients, and between different ethnic groups. We found that approximately 1 in 109 people will develop vitiligo over their lifetime. This risk is similar for both female and male individuals. There are striking differences between ethnic groups. People of Asian ethnicity have almost 5 times the risk of getting vitiligo than people belonging to White ethnic groups. One in 28 people of Asian ethnicity will develop vitiligo. We also found that vitiligo had a wide range of impacts. People with vitiligo have a greater risk of depression, anxiety and sleep disturbance. People with vitiligo have contact with their general practices more often. They also have more time off work than people without vitiligo. These impacts are similar for people of different ethnic groups. Our study shows the risk of vitiligo varies in different ethnic groups. Our results can help healthcare professionals identify people who may need more support.
© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists.
Conflict of interest statement
Conflicts of interest V.E. has received honoraria and/or support for academic work from Incyte, Almirall, Pfizer, AbbVie and La Roche-Posay. V.E. is a member of the Research Sub-committee of the Executive Committee of the British Association of Dermatologists (BAD) and a member of the Therapy and Guidelines Sub-Committee of the BAD. A.A. reports ad hoc consultancy for AbbVie, Almirall, Emma Hardie, Garnier, LEO Pharma, L’Oréal, Proctor & Gamble, Neutrogena, NIVEA, Novartis, PRAI Beauty, Revive Collagen, Sanofi, The Body Shop, UCB and Unilever; has held a position of interest for the Trial Generation and Prioritisation Panel (UK Dermatology Clinical Trials Network); and is an Executive Committee Member Psychodermatology UK and the BAD. J.N. and R.N. are employees of and shareholders in Pfizer Ltd.
Publication types
MeSH terms
Associated data
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
