The global epidemiology of vitiligo: A systematic review and meta-analysis of the incidence and prevalence

Abstract

Vitiligo is described with a prevalence of 0.5%−1%. Recent studies suggest an increasing prevalence, but there is a scarcity of studies that have systematically evaluated the global incidence and prevalence. We examined the incidence and the global, regional, and country-specific prevalence of vitiligo in the general population (PROSPERO: CRD42021261643). We systematically searched PubMed, EMBASE, and Web of Science. Each study was categorised in subgroups. The overall analysis comprised all studies, except for studies only examining children and adolescents. Pooled proportions were calculated with the DerSimonian-Laird method for random-effects models with 95% confidence intervals (CI). Of the 7,838 identified studies, 171 were eligible for analysis (participants n = 572,334,973). The overall incidence was 1.59 per 10,000 person-years (95% CI: 0.70−2.83). The overall prevalence was 0.40% (95% CI: 0.37−0.44); no difference was observed between females (0.50%, 95% CI: 0.36−0.66) and males (0.49%, 95% CI: 0.35−0.65). West Asia showed the highest prevalence (0.77%, 95% CI: 0.44−1.10) and East Asia the lowest (0.12%, 95% CI: 0.10−0.14). The highest country-specific prevalence was reported in Jordan (1.34%, 95% CI: 0.12−3.87) and the lowest in Sweden (0.19%, 95% CI: 0.08−0.34). Children and adolescents showed a lower prevalence (0.27%, 95% CI: 0.24−0.31) compared to adults (0.70%, 95% CI: 0.59−0.81). Questionnaire-based studies showed a higher prevalence (0.73%, 95% CI: 0.52−0.98) compared to examination-based studies (0.59%, 95% CI: 0.46−0.73) and register-based studies (0.13%, 95% CI: 0.10−0.17). The prevalence in examination-based studies increased from 0.40% (95% CI: 0.17−0.73) between 1943 and 1979 to 0.89% (95% CI: 0.68−1.13) between 2020 and 2023. Questionnaire-based studies also showed an increasing prevalence, while in register-based studies, the prevalence was continuously low. This study shows the global impact of vitiligo and how subgroup analyses influence the prevalence. The overall prevalence of vitiligo is lower than previously assumed; females and males are equally affected, and vitiligo is more common in adults.