Stigma Experience in Patients With Vitiligo: A Comprehensive Study in a Skin Hospital


Vitiligo is the most common cause of skin depigmentation, which relates to a wide range of psychological disorders. Stigma is defined as a negative attitude towards oneself that results from one's perception of being different from the general population. In this study, we have evaluated the quality of life and stigmatization degree among vitiligo patients. In this cross-sectional study, 323 patients with vitiligo referred to Razi Hospital, Tehran, Iran, were evaluated. All patients were asked to fill out a questionnaire containing age, gender, marital status, educational level, employment status, duration of vitiligo, location of lesions, history of underlying diseases, history of previous treatments, as well as history of depression or suicide. Quality of life and stigmatization among patients were assessed by DLQI (dermatology life quality index) and FSQ (feeling stigmatization questionnaire) questionnaires. The prevalence of moderate and severe stigmatization were 49.8 % and 13.3%, respectively. Women were significantly more stigmatized than men. The presence of vitiligo lesions on the face, hands, or forearms, previous topical and oral treatments, and prior depressive disorders were significantly associated with an increased sense of stigma. Patients with thigh or trunk lesions faced less stigmatization. Additionally, stigmatization was meaningfully related to the level of quality of life impairment. In the present study, 63% of patients with vitiligo experienced moderate to severe stigmatization levels related to gender, lesion site, history of prior treatments, and depression. Moreover, there was a significant correlation between the level of stigma sensation and the life quality disturbance.

1. Yaghoobi, R., M. Omidian, and N. Bagherani, Vitiligo: a review of the published work. The Journal of dermatology, 2011. 38(5): p. 419-431.
2. Faria, A.R., et al., Vitiligo-Part 2-classification, histopathology and treatment. Anais brasileiros de dermatologia, 2014. 89(5): p. 784-790.
3. Alkhateeb, A., et al., Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Research, 2003. 16(3): p. 208-214.
4. Grimes, P.E., New insights and new therapies in vitiligo. Jama, 2005. 293(6): p. 730-735.
5. Mohammed, G.F., A.H. Gomaa, and M.S. Al-Dhubaibi, Highlights in pathogenesis of vitiligo. World Journal of Clinical Cases: WJCC, 2015. 3(3): p. 221.
6. Majumder, P.P., S. Das, and C. Li, A genetical model for vitiligo. American journal of human genetics, 1988. 43(2): p. 119.
7. Nath, S.K., P.P. Majumder, and J.J. Nordlund, Genetic epidemiology of vitiligo: multilocus recessivity cross-validated. American journal of human genetics, 1994. 55(5): p. 981.
8. Ezzedine, K., et al., Revised classification/nomenclature of vitiligo and related issues: the Vitiligo Global Issues Consensus Conference. Pigment cell & melanoma research, 2012. 25(3): p. E1-E13.
9. Khalil, A., et al., Autoimmune complications after hematopoietic stem cell transplantation in children with nonmalignant disorders. The Scientific World Journal, 2014. 2014.
10. Cupertino, F., J.P. Niemeyer-Corbellini, and M. Ramos-e-Silva, Psychosomatic aspects of vitiligo. Clinics in dermatology, 2017. 35(3): p. 292-297.
11. Thompson, A., et al., Vitiligo linked to stigmatization in British South Asian women: a qualitative study of the experiences of living with vitiligo. British Journal of Dermatology, 2010. 163(3): p. 481-486.
12. Ibler, K.S. and G.B. Jemec, Cumulative life course impairment in other chronic or recurrent dermatologic diseases, in Dermatological Diseases and Cumulative Life Course Impairment. 2013, Karger Publishers. p. 130-136.
13. Rzepa, T., et al., Disease-induced level of shame in patients with acne, psoriasis and syphilis. Advances in Dermatology and Allergology/Postȩpy Dermatologii I Alergologii, 2013. 30(4): p. 233.
14. Temel, A.B., et al., Internalized stigma in patients with acne vulgaris, vitiligo, and alopecia areata. Turkish Journal of Dermatology, 2019. 13(3): p. 109.
15. Kota, R.S., et al., Study on assessment of quality of life and depression in patients of vitiligo. Indian dermatology online journal, 2019. 10(2): p. 153.
16. Sangma, L.N., J. Nath, and D. Bhagabati, Quality of life and psychological morbidity in vitiligo patients: a study in a teaching hospital from north-East India. Indian journal of dermatology, 2015. 60(2): p. 142.
17. Boza, J.C., et al., Quality of life impairment in children and adults with vitiligo: a cross-sectional study based on dermatology-specific and disease-specific quality of life instruments. Dermatology, 2016. 232(5): p. 619-625.
18. Saitta, P., et al., An update on the presence of psychiatric comorbidities in acne patients, Part 2: Depression, anxiety, and suicide. Cutis, 2011. 88(2): p. 92-97.
19. Porter, J.R. and A.H. Beuf, Racial variation in reaction to physical stigma: a study of degree of disturbance by vitiligo among black and white patients. Journal of Health and Social Behavior, 1991: p. 192-204.
20. Sawant, N.S., N.A. Vanjari, and U. Khopkar, Gender differences in depression, coping, stigma, and quality of life in patients of vitiligo. Dermatology research and practice, 2019. 2019.
21. Pichaimuthu, R., et al., A measurement of the stigma among vitiligo and psoriasis patients in India. Indian Journal of Dermatology, Venereology, and Leprology, 2011. 77(3): p. 300.
22. Schmid‐Ott, G., et al., Stigmatization experience, coping and sense of coherence in vitiligo patients. Journal of the European Academy of Dermatology and Venereology, 2007. 21(4): p. 456-461.
IssueVol 60, No 7 (2022) QRcode
Vitiligo Stigma Quality of life Autoimmune diseases Skin diseases

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Zare Dehnavi A, Daneshpazhooh M, Dehghani A, Balighi K, Azizpour A, Yaseri M, Seyed Ebrahimi SM, Mahmoudi H. Stigma Experience in Patients With Vitiligo: A Comprehensive Study in a Skin Hospital. Acta Med Iran. 2022;60(7):422-428.