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Clinical determinants of health-related quality of life in Vitiligo: a cross-sectional analysis from Kandahar, Afghanistan
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 14 May 2026
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Vitiligo substantially impairs health-related quality of life (HRQoL), yet the independent impact of clinical characteristics remains inconsistent across populations. Data from Afghanistan are limited despite potential sociocultural influences. This multicenter cross-sectional study evaluated independent associations of disease severity, activity, duration, and extent with HRQoL among 402 adults with clinically confirmed vitiligo in Kandahar. Disease severity was assessed using the Vitiligo Area Severity Index (VASI), along with anatomical extent and activity status. HRQoL was measured using the Dermatology Life Quality Index (DLQI). Multivariable linear regression analyses with robust standard errors were adjusted for age, sex, and psychological distress. The mean DLQI score was 5.1±3.0. VASI demonstrated a weak but statistically significant correlation with DLQI (r=0.135; p=0.007). Moreover, higher VASI scores independently predicted poorer HRQoL (β=0.071; p=0.008). Stable and repigmenting disease was associated with an approximately 1.18-point higher DLQI score compared with progressive disease (p<0.001). Disease duration and anatomical extent were not independent predictors. The model explained 18.4% of DLQI variance. Severity and activity were the principal correlates of HRQoL impairment.
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1. Akl J, Lee S, Ju HJ, et al. Estimating the burden of vitiligo: a systematic review and modelling study. Lancet Public Health 2024;9:e386-96.
2. Krüger C, Schallreuter KU. A review of the worldwide prevalence of vitiligo in children/adolescents and adults. Int J Dermatol 2012; 51:1206-12.
3. Al Hammadi A, Silva de Castro CC, Parmar NV, et al. Prevalence and burden of vitiligo in Africa, the Middle East and Latin America. Skin Health Dis 2023;4:e317.
4. Taïeb A, Picardo M. Vitiligo. N Engl J Med 2009;360:160-9.
5. Ezzedine K, Eleftheriadou V, Jones H, et al. Psychosocial effects of vitiligo: a systematic literature review. Am J Clin Dermatol 2021;22:757-74.
6. Morrison B, Burden-Teh E, Batchelor JM, et al. Quality of life in people with vitiligo: a systematic review and meta-analysis. Br J Dermatol 2017;177:e338-9.
7. Picardo M, Huggins RH, Jones H, et al. The humanistic burden of vitiligo: a systematic literature review of quality-of-life outcomes. J Eur Acad Dermatol Venereol 2022;36:1507-23.
8. Rosmarin D, Soliman AM, Piercy J, et al. Health-related quality of life burden among adults with vitiligo: relationship to disease severity and disease location. Dermatol Ther (Heidelb) 2024;14:1633-47.
9. Silverberg JI, Silverberg NB. Association between vitiligo extent and distribution and quality-of-life impairment. JAMA Dermatol 2013;149:159-64.
10. Bae JM, Lee SC, Kim TH, et al. Factors affecting quality of life in patients with vitiligo: a nationwide study. Br J Dermatol 2018;178:238-44.
11. Hedayat K, Karbakhsh M, Ghiasi M, et al. Quality of life in patients with vitiligo: a cross-sectional study based on vitiligo quality of life index (VitiQoL). Health Qual Life Outcomes 2016;14:86.
12. Morales-Sánchez MA, Vargas-Salinas M, Peralta-Pedrero ML, et al. Impact of vitiligo on quality of life. Actas Dermosifiliogr 2017;108:637-42.
13. Florez-Pollack S, Jia G, Zapata L Jr, et al. Association of quality of life and location of lesions in patients with vitiligo. JAMA Dermatol 2017;153:341-2.
14. van Geel N, Speeckaert R, Taïeb A, et al. 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. J Eur Acad Dermatol Venereol 2023;37:2173-84.
15. Rahimi BA, Farooqi K, Fazli N. Clinical patterns and associated comorbidities of vitiligo in Kandahar, Afghanistan: a case-control study. Our Dermatol Online 2020;11:8-12.
16. Hooshmand AM, Shayan NA. Impact of vitiligo on quality of life of patients in Herat, Afghanistan. Iran J Dermatol 2021;24:220-6.
17. National Statistics and Information Authority. Afghanistan statistical yearbook 2018-19 [Internet]. NSIA; 2019. Available from: https://www.cawater-info.net/afghanistan/pdf/afg-stat-yearbook-2018-e.pdf.
18. Bibeau K, Ezzedine K, Harris JE, et al. Mental health and psychosocial quality-of-life burden among patients with vitiligo: findings from the global VALIANT study. JAMA Dermatol 2023;159:1124-8.
19. Babyak MA. What you see may not be what you get: a brief, nontechnical introduction to overfitting in regression-type models. Psychosom Med 2004;66:411-21.
20. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Routledge; 1988.
21. Hamzavi I, Jain H, McLean D, et al. Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the vitiligo area scoring index. Arch Dermatol 2004;140:677-83.
22. Pourang A, Kohli I, Ezekwe N, et al. Reliability of the vitiligo area scoring index measurement tool for vitiligo. JAAD Int 2023;16:206-13.
23. Finlay AY, Khan GK. Dermatology life quality index (DLQI)—a simple practical measure for routine clinical use. Clin Exp Dermatol 1994;19:210-6.
24. Yan H, Thomas CL, Harrison MA, et al. Translating the science of quality of life into practice: what do dermatology life quality index scores mean? J Invest Dermatol 2005;125:659-64.
25. Basra MKA, Fenech R, Gatt RM, et al. The dermatology life quality index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol 2008;159:997-1035.
26. Vyas J, Johns JR, Ali FM, et al. A systematic review of 454 randomized controlled trials using the dermatology life quality index: experience in 69 diseases and 43 countries. Br J Dermatol 2024;190:315-39.
27. Goldberg DP, Gater R, Sartorius N, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med 1997;27:191-7.
28. Picardi A, Abeni D, Mazzotti E, et al. Screening for psychiatric disorders in patients with skin diseases: a performance study of the 12-item general health questionnaire. J Psychosom Res 2004;57:219-23.
29. Malik YK, Singla S, Dayal S, et al. Body surface area and vitiligo hue: quality of life and depression, anxiety, stress symptoms. J Psychosom Res 2023;172:111438.
30. Lacerda KAP, Silva LA, Mendonca GS, et al. Association between quality of life and perceived stress in patients with vitiligo: case-control study. Biosci J 2020;36:1032-42.
31. Chernyshov PV, Tomas-Aragones L, Manolache L, et al. Quality of life measurement in vitiligo: position statement of the European Academy of Dermatology and Venereology task force on quality of life and patient-oriented outcomes with external experts. J Eur Acad Dermatol Venereol 2023;37:21-31.
32. Yang TT, Lee CH, Lan CCE. Impact of vitiligo on life quality of patients: assessment of currently available tools. Int J Environ Res Public Health 2022;19:14943.
33. Lilly E, Lu PD, Borovicka JH, et al. Development and validation of a vitiligo-specific quality-of-life instrument (VitiQoL). J Am Acad Dermatol 2013;69:e11-8.
How to Cite
1.
Farooqi K, Sharma SK, Tareen Z, Wafa MH, Baray AH. Clinical determinants of health-related quality of life in Vitiligo: a cross-sectional analysis from Kandahar, Afghanistan. Dermatol Reports [Internet]. 2026 May 14 [cited 2026 May 20];. Available from: https://journals.pagepress.net/dr/article/view/10828
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