Clinical Profile and Quality of Life in Patients with Resistant to Treatment Vitiligo Lesions in Iran: Vitiligo Patients need Medico-psycho-social Assistance

Background: Vitiligo is a common chronic disease associated with physical effects, psychological impacts, and impaired quality of life (QoL). Lesions in acral areas are resistant to treatments. Since these areas are exposed and visible, they have a profound effect on patients' self-confidence. Despite the high prevalence of these conditions, information in this field, especially for Iranian patients, is scarce. Objectives: To study the clinical profile of patients with vitiligo lesions in the acral areas, assess the burden of QoL impairment, and investigate the association between patient's characteristics and their QoL outcomes Methods: A total of 84 patients with non-segmental vitiligo who had involvement in resistant treatment areas were recruited in this study. Clinical characteristics and disease outcomes, with a special emphasis on the quality of life (QoL), were investigated using the Dermatology Life Quality Index (DLQI) questionnaire. Furthermore, the extent of the disease was calculated by utilizing the Vitiligo Area Scoring Index (VASI). Descriptive and comparative analyses were conducted using SPSS software (version 29). Results: The most common comorbidity observed among the patients was various types of immune diseases. The mean total score of DLQI was 8.1, indicating a moderate effect of the disease on the patient's life since the score falls within the range of 6-10. The Kruskal-Wallis non-parametric test illustrated a significant difference in QoL among different age groups (P=0.020). The results indicated a positive, direct, and significant relationship between the extent of the disease and DLQI (r=0.269,;P=0.013). Nonetheless, the relationship between the engagement of the genital area in married patients and difficulties in sexual relations was not found to be statistically significant at α=0.05. Conclusion: The involvement of end-extremities based on existing studies is a frequent occurrence in vitiligo. These affected areas hold considerable significance in terms of the patient's quality of life (QoL) due to their prominent visibility and resistance to available treatments. Considering the high prevalence of psychological consequences, diversity in skin phototypes, and social acceptance, regional studies are necessary for more efficient and responsive medical management integrated with psychosocial assistance.