Validation of a Patient Global Assessment for extent, severity and impact to define the severity strata for the Self Assessment Vitiligo Extent Score (SA‐VES)

Geel, Nanja van; Uitentuis, Sanne E.; Zuidgeest, Marloes; Wolkerstorfer, Albert; Bekkenk, Marcel W.; Moock, Charlotte; Goethem, Cedric Van; Verlaeckt, E; Smet, Cindy de; Grine, Lynda; Speeckaert, Reinhart

doi:10.1111/jdv.16562

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…It can be rated by clinician-reported methods where higher grades correspond to more severe disorder [77][78][79]: body surface area (BSA, the percentage of lesions affected), Vitiligo Area Scoring Index (VASI, BSA*residual depigmentation, ranging from 0 to 100), newly developed Vitiligo Extent Score (VES, 0-6 degree of the affection extent), and Vitiligo Disease Activity (VIDA) scores (− 1 to 4 point scale). In parallel, self-assessment tools have also been introduced including Self Assessment Vitiligo Extent Score (SA-VES) e Trichrome lesions (black arrows) and poorly defined borders (white arrows) [80,81] and Self Assessed Vitiligo Area Scoring Index (SA-VASI) [82]. Up till now, there are no standardized methods.…”

Section: Diagnosis Differential Diagnosis and Disease Assessmentmentioning

confidence: 99%

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Wang

2021

Clinic Rev Allerg Immunol

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Vitiligo is an autoimmune disease of the skin characterized by epidermal melanocyte loss resulting in white patches, with an approximate prevalence of 0.5-2% worldwide. Several precipitating factors by chemical exposure and skin injury present commonly in patients with vitiligo. Although the diagnosis appears to be straightforward for the distinct clinical phenotype and specific histological features, vitiligo provides many challenges including chronicity, treatment resistance, frequent relapse, associated profound psychosocial effect, and negative impact on quality of life. Multiple mechanisms are involved in melanocyte disappearance, including genetics, environmental factors, and immune-mediated inflammation. Compelling evidence supports the melanocyte intrinsic abnormalities with poor adaptation to stressors leading to instability and release of danger signals, which will activate dendritic cells, natural killer cells, and innate lymphoid cells to initiate innate immunity, ultimately resulting in T-cell mediated adaptive immune response and melanocyte destruction. Importantly, the cross-talk between keratinocytes, melanocytes, and immune cells, such as interferon (IFN)-γ signaling pathway, builds inflammatory loops that give rise to the disease deterioration. Improved understanding of the immune pathogenesis of vitiligo has led to the development of new therapeutic options including Janus kinase (JAK) inhibitors targeting IFN-γ signaling pathways, which can effectively reverse depigmentation. Furthermore, definition of treatment goals and integration of comorbid diseases into vitiligo management have revolutionized the way vitiligo is treated. In this review, we highlight recent developments in vitiligo clinical aspects and immune pathogenesis. Our key objective is to raise awareness of the complexity of this disease, the potential of prospective therapy strategies, and the need for early and comprehensive management.

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Section: Diagnosis Differential Diagnosis and Disease Assessmentmentioning

confidence: 99%

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Wang

2021

Clinic Rev Allerg Immunol

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“…For target lesions, mostly in the context of clinical trials, digital image analysis can be proposed 19 . Stratification of extent and severity into global categories (limited/mild, moderate, extensive/severe) based on one study (patients' perspective) was as follow: Extent ≤1.05% BSA for limited, >1.05%–6.45% for moderate and >6.45% for extensive, Severity ≤2.07% BSA for mild, >2.07%–4.8% for moderate and >4.8% for severe 20‐22 . Extent represents only one aspect of the ‘severity’ perception from the patients' perspective; therefore, other items need to be taken into account, for instance, location of lesions (visible areas), disease impact, skin phototype and disease activity 21 …”

Section: Severity Scoring Methodsmentioning

confidence: 99%

“…Vitiligo global Impact scale 0 to 10 or 5‐point scale), or with a more comprehensive burden scale [e.g. Vitiligo Impact Patient Scale (VIPs), Vitiligo Quality of Life scale (VitiQOL) and Vitiligo Impact Scale (VIS‐22)] 21,22,28‐33 …”

Section: Assessment Of the Disease Burdenmentioning

confidence: 99%

“…Vitiligo Impact Patient Scale (VIPs), Vitiligo Quality of Life scale (VitiQOL) and Vitiligo Impact Scale (VIS-22)]. 21,22,[28][29][30][31][32][33] Management of the psychological implications of vitiligo is an important aspect of overall disease management. 34 Psychological support includes but is not limited to counselors, psychologists and psychiatrists, and depends on local resources, networking and the extent of the morbidity.…”

Section: Asse Ssm E N T Of Th E Dise Ase Bu R De Nmentioning

confidence: 99%

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Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the International Vitiligo Task Force Part 1: towards a new management algorithm

van Geel,

Speeckaert,

Taïeb

et al. 2023

Acad Dermatol Venereol

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BackgroundThe treatment of vitiligo can be challenging and depends on several factors such as the subtype, disease activity, vitiligo extent, and treatment goals. Vitiligo usually requires a long‐term approach. To improve the management of vitiligo worldwide, a clear and up‐to‐date guide based on international consensus with uniform stepwise recommendations is needed.ObjectivesTo reach an international consensus on the nomenclature and to develop a management algorithm for the diagnosis, assessment, and treatment of vitiligo.MethodsIn this consensus statement, a consortium of 42 international vitiligo experts and four patient representatives participated in online and live meetings to develop a consensus management strategy for vitiligo. At least two vitiligo experts summarized the evidence of topics included in the algorithms. A survey was utilized to resolve remaining issues among a core group of eight experts. Subsequently, the unanimous recommendations were finalized and validated based on further input from the entire group during two live meetings.ResultsThe algorithms highlight the importance of shared decision‐making. Dermatologists are encouraged to provide patients with detailed explanations of the prognosis and expected therapeutic outcomes based on clinical examination. The treatment goal should be discussed and clearly emphasized to patients given the different approaches for disease stabilization and repigmentation. The evaluation of disease activity remains a cornerstone in the tailor‐made approach to vitiligo patients.ConclusionsThese new treatment algorithms are intended to guide clinical decision‐making in clinical practice. Promising novel therapies for vitiligo are on the horizon, further highlighting the need for reliable outcome measurement instruments and greater emphasis on shared decision‐making.

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“…Considering that only 15% of vitiligo cases are Non-Segmental vitiligo (NSV) [37][38][39][40], we estimated a total of 279,000 NSV patients in Italy in 2022. Among these, 152,000 received a diagnosis, with 33% classified as having BSA <0.5% (Not Severe at all), 31% with BSA 0.5%-3.5% (Mild), 27% with BSA 3.5%-10% (Moderate/Severe), and 9% with BSA >10% (Very Severe) [41].…”

Section: Epidemiologymentioning

confidence: 99%

Vitiligo: Epidemiology and Economic Impact

Naldi,

Pagani,

Alduini

2023

Dermatol Pract Concept

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Introduction: Vitiligo is an acquired disorder of pigmentation, characterized by the development of white patches on the skin, often with a typical symmetrical distribution and progressive extension [1,2]. Although vitiligo does not cause direct physical impairment, it can produce a relevant psychosocial burden. Despite this burden, effective treatments are lacking, emphasizing the need for new therapeutic options. Objectives: The aim of this study was to systematically scan the scientific literature for studies dealing with vitiligo epidemiology. Additionally, the study aimed to assess the social costs of vitiligo, ultimately raising awareness about the societal impact of the condition. The focus was on Italian data. Methods: Our research employed a comprehensive methodology. For the epidemiology, we systematically searched PubMed database up to October 2023 and complemented the analysis with Real World Evidence. For social costs, we conducted an in-depth literature review, administered a web-survey to 20 Italian dermatologists and conducted an equivalent number of interviews during the same period in March 2022. Results: The data suggest that in Italy the prevalence of vitiligo increases with age, and it varies from 0.19% (age 18-21) to 0.6% (age >45) [3,4]. We estimated 152,000 patients diagnosed with Non-Segmental Vitiligo (NSV) in Italy; based on Body Surface Area (BSA), 33% are Not Severe, 31% Mild, 27% Moderate/Severe, 9% Very Severe. The yearly social costs of vitiligo amount to €0.5Bln. Conclusions: There is a remarkable association of vitiligo with anxiety and depression [5,6,7,8,9], and Mental Health is associated with 30% of social costs. Moreover, vitiligo social costs distribution highlights inequity, with patients bearing 55% of them.

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Validation of a Patient Global Assessment for extent, severity and impact to define the severity strata for the Self Assessment Vitiligo Extent Score (SA‐VES)

Cited by 5 publications

References 12 publications

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Clinical Features, Immunopathogenesis, and Therapeutic Strategies in Vitiligo

Worldwide expert recommendations for the diagnosis and management of vitiligo: Position statement from the International Vitiligo Task Force Part 1: towards a new management algorithm

Vitiligo: Epidemiology and Economic Impact

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