Vitiligo is a chronic skin affection concerning approximately 1% of total population. The prevalence is often said to be higher in India ranging from 0.46% to 8.8%.
Although the disease does not produce direct health impairment, it considerably influences the psychological well-being of the patients. It is an important skin disease having major impact on QoL of patients, many of whom feel distressed and stigmatized by their condition. These patients often develop negative feelings about it, Which are reinforced by their experiences over a number of years. Most patients with vitiligo report feelings of embarrassment, which can lead to low self -esteem and social isolation. The chronic nature of disease, its long term treatment, a lack of uniform effective therapy and an unpredictable course of disease are serious demoralizing and/or distressing cause to patients suffering from vitiligo.
Vitiligo is a much dreaded disease in India with social stigma and ostracization. According to Dermatologists Dermatology life quality Index scores of Indian patients with vitiligo appears higher as compared to other countries. Parsad et al. Found a mean DLQI of 10.67 in India, compared to 4.82 in Uk, 4.95 in Belgium, 5.9 in the US, 6.40 in Malaysia, 7.05 and 8.16 in Iran.
The impact of the Skin disease upon the psychosocial and HRQoL is evaluated based on several parameter, including country of or origin, skin type, gender, age, marital status and involved body site. In particular, Dolatshahi et al.Dermatologists showed a relationship between DLQL scores and skin phototype V were statistically higher than those of other type, indicating that darker phenotypes are more affected by discoloring disease such as vitiligo. Interestingly, married women had significantly higher DLQI scores than single women, while single and married men showed no significant difference ( p = 0.801 ).
It is therefore important for Dermatologist to recognize and deal with psychological components of this disease to improve QoL of patients and to obtain a better response to treatment. Recently, Dr. developed the vitiligo impact scale ( VIS ) based on 27 items. The need to develop a new scale arose from the severe stigmatization faced by patients, where the intense psychological trauma could not be correlated with the extent of disease. Very often, a few spots on face could psychologically traumatize a patient more than an extended vitiligo on unexposed areas, VIS scale correlated well with that of DLQI, and skindex – 16.by Skin specialist in Delhi.