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Vitiligo: 40% of cases in the U.S. may be undiagnosed

Photo by: Grook Da Oger via Wikimedia Commons

An online survey of nearly 41,000 people in the U.S. has concluded that the prevalence of vitiligo may be much higher than reported. The results of the survey were published in JAMA Dermatology (2021 Nov 17;e214724. doi: 10.1001/jamadermatol.2021.4724, online ahead of print).

“Vitiligo can have profound effects on patients and is often associated with other autoimmune comorbid conditions,” Kavita Gandhi, MS, BSPharm, and colleagues wrote. “It is important to understand the current prevalence of vitiligo.”

Participation in the cross-sectional online survey to determine self-reported vitiligo status was offered to 322,240 people in the U.S. A total of 60,524 (18.8%) responded, and 40,888 of those were considered eligible for the study. They received surveys between Dec. 2019 and March 2020.

The completed surveys were evaluated by three dermatologists who determined if the vitiligo was diagnosed, undiagnosed or a subtype (non-segmental or segmental). The dermatologists also reviewed a limited number of photographs uploaded by the participants using a teledermatology app specifically designed for this study. The mean age of the respondents was 44.9 (17.4) years, 23,170 (56.7%) were female, 30,428 (74.4%) were White, and 4,225 (10.3%) were of Hispanic, Latino or Spanish origin.

According to the study results, self-reported vitiligo prevalence was 1.38% (95% CI, 1.26%-1.49%), with 0.77% (95% CI, 0.68%-0.85%) for diagnosed and 0.61% (95% CI, 0.54%-0.69%) for undiagnosed. When 113 submitted photographs of participants with self-reported vitiligo were reviewed by the dermatologists, the clinician-adjudicated vitiligo prevalence (sensitivity bounds) was 0.76% (0.76%-1.11%), with 0.46% (0.46%-0.61%) for diagnosed and 0.29% (0.29%-0.50%) for undiagnosed. Non-segmental and segmental rates were also determined.

“Results of this survey study demonstrated that the current US population-based prevalence estimate of overall (diagnosed and undiagnosed combined) vitiligo in adults is between 0.76% (1.9 million cases in 2020) and 1.11% (2.8 million cases in 2020),” the authors conclude. They report that further studies should be conducted to confirm these findings.

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