Incidence and Prevalence of Diagnosed Vitiligo According to Race and Ethnicity, Age, and Sex in the US

Abstract

ImportanceVitiligo has substantial psychosocial consequences. Yet its burden is poorly established.ObjectiveTo estimate incidence and prevalence of diagnosed vitiligo across age, sex, and racial and ethnic subgroups in the US.Design, Setting, and ParticipantsThis analysis comprising a cohort study and cross-sectional study included electronic health records for health care–seeking children, adolescents, and adults across 4 US census regions. Data for the incidence analysis were obtained from January 1, 2015, through December 31, 2019, and data for the prevalence analysis were obtained from January 1 through December 31, 2019. Data were analyzed from December 13, 2022, to June 8, 2023.Main Outcomes and MeasuresThe main outcomes were incidence (per 100 000 person-years [PY]) and prevalence of diagnosed vitiligo overall and by age, race and ethnicity, and sex.ResultsA total of 2 980 778 patients with vitiligo were included in the incidence analysis (mean [SD] age, 41.5 [24.0] years; 57.0% female; 1.4% Asian American; 12.9% Black; 1.5% Hispanic/Latino; 77.3% White; 6.9% other or multiracial) and 1 057 534 in the prevalence analysis (mean [SD] age, 43.4 [24.7] years; 57.5% female; 1.7% Asian American, 14.7% Black, 1.4% Hispanic/Latino; 75.7% White; 6.6% other or multiracial). Age- and sex-adjusted overall incidence rate (IR) of diagnosed vitiligo was 22.6 per 100 000 PY (95% CI, 21.5-23.8 per 100 000 PY), and prevalence was 0.16% (95% CI, 0.15%-0.17%). Sex-adjusted IR was highest among patients aged 60 to 69 years (25.3 per 100 000 PY; 95% CI, 22.2-28.6 per 100 000 PY), and prevalence was highest among patients aged 70 years or older (0.21%; 95% CI, 0.19%-0.23%). The highest age-adjusted IR was observed among Asian American patients (41.2 per 100 000 PY; 95% CI, 28.2-58.2 per 100 000 PY), followed by Hispanic/Latino patients (37.3 per 100 000 PY; 95% CI, 25.7-52.4 per 100 000 PY), patients reporting other or multiple races (31.1 per 100 000 PY; 95% CI, 25.9-37.1 per 100 000 PY), Black patients (29.6 per 100 000 PY; 95% CI, 26.0-33.6 per 100 000 PY), and White patients (18.7 per 100 000 PY; 95% CI, 17.5-20.0 per 100 000 PY). The highest age-adjusted prevalence was observed among Hispanic/Latino patients (0.29%; 95% CI, 0.20%-0.39%), followed by Asian American patients (0.27%; 95% CI, 0.19%-0.35%), patients reporting other or multiple races (0.24%; 95% CI, 0.20%-0.28%), Black patients (0.22%; 95% CI, 0.19%-0.24%), and White patients (0.13%; 95% CI, 0.12%-0.14%).Conclusions and RelevanceThis cross-sectional study found that vitiligo diagnosis was more common in older patients, Hispanic/Latino patients, and Asian American patients.

Strengths and Limitations of Study Designs Using Administrative Data to Assess Incidence and Prevalence of Disease

“…Because vitiligo may be less apparent and bothersome for those with fair skin, the true prevalence of vitiligo may be higher than what was observed in this study. 1 Similar issues may occur for those who face barriers to care. Notably, a population-based study of adults in the US found 5-fold to 10-fold higher rates of vitiligo prevalence and did not find any statistically significant differences by race and ethnicity.…”

“…In this issue of JAMA Dermatology, using the IBM Explorys database, Mastacouris et al 1 estimate the incidence and prevalence of vitiligo by race and ethnicity, age, and sex in the US. This article adds to our knowledge about the underlying epidemiology of vitiligo, particularly concerning demographic subgroups and pediatric populations.…”

“…As a result, a validation study to examine the sensitivity and specificity of the proposed classification approach should be conducted before the study evaluating incidence and prevalence. Although one might expect vitiligo ICD codes to be relatively specific, there is a need for validation studies to verify the classification accuracy of the vitiligo case definition used by Mastacouris et al 1 in the present analysis.…”

“…In addition, for conditions where individuals may not always seek care, populationbased studies can provide valuable complementary information to address some of the limitations of study designs using administrative data. The current study by Mastacouris et al 1 highlights important areas for future study, such as differences in the incidence and prevalence of vitiligo by age as well as by race and ethnicity.…”

Case Report: Successful treatment with methotrexate in a 10-year-old boy with co-occurrence of generalized psoriasis and vitiligo

“…Psoriasis (PsO) is more prevalent in Northern European nations than in East Asia ( 1 ), and vitiligo is less common among Asian Americans than individuals of other races ( 2 ). Consequently, the co-occurrence of PsO and vitiligo is frequent in Europe and the Americas but rare in Asia, especially among children under 10 years of age.…”