Guidelines on managing people with vitiligo

Abstract

Abstract Linked Article: Eleftheriadou et al. Br J Dermatol 2022; 186:18–29. Vitiligo is a common, long-term skin condition. It affects approximatively 1% of the world’s population, regardless of age, sex or race. The type of vitiligo and its stability help indicate the chance of improvement (or chance of relapse). In people with vitiligo not enough melanin is produced in the body, which leads to pale, white or light pink patches on the skin. Sometimes, these patches can merge to form larger areas. In rare cases, over 80% of the body surface can be affected. However, vitiligo appears most commonly on the face, neck, hands, body openings (nostrils, mouth, genitals, navel and around the eyes) and skinfolds (the underarms and groin area). The British Association of Dermatologists (BAD) formed a group of experts made up dermatologists, clinical psychologists, patient representatives and a technical team. They reviewed relevant articles published up to May 2019 to produce evidence-based recommendations using the rigorous GRADE system (Grading of Recommendations Assessment, Development and Evaluation) for guideline development. The guideline has 28 management recommendations, nine future research recommendations and five recommended audit points (audit points are used by health professionals to assess, evaluate and improve the quality of care received by patients in a systematic way). The management approach is presented as a flow diagram, allowing clinicians to see at a glance the key recommended actions when treating people with vitiligo. Based on the experience of the group, people with vitiligo may experience high levels of social anxiety, stigma and discrimination. They recommended, alongside the recommended treatments, routine assessment of patients’ quality of life, and mental and social wellbeing. People with vitiligo should also be offered information on self-help, and where appropriate, referred for psychological therapy. The guideline was used to update the BAD’s Patient Information Leaflet (PIL) for vitiligo, which can be accessed on the BAD website (www.skinhealthinfo.org.uk/a-z-conditions-treatments/). Linked Article: Eleftheriadou et al. Br J Dermatol 2022; 186:18–29.