Assessing Treatment Delays for Vitiligo Patients: A Retrospective Chart Review
Many barriers to care exist for vitiligo patients that can impact patients’ quality of life. Because early treatment of vitiligo is more efficacious, we investigated the factors associated with delay to treatment via a retrospective chart review of 102 consecutive patients attending an academic outpatient clinic over a 36-month time frame. Demographic information, clinical characteristics of vitiligo, and treatment details were obtained via a standardized questionnaire given to all patients with vitiligo. Our findings emphasize the need to investigate barriers to care to reduce health disparities among individuals with vitiligo.
Practice Points
- The medical community should be aware of factors associated with delay to treatment in patients with vitiligo, such as the diagnosing physician’s specialty and patient age at disease onset.
- Race and percentage of body surface area affected at time of presentation also demonstrate trends regarding treatment delays in patients with vitiligo.
Diagnosis of Vitiligo by Nondermatologists—The increase in delay to treatment when a nondermatologist diagnoses vitiligo suggests that prompt initiation of treatment or referrals to dermatology by primary care providers may not routinely be occurring.4 Our data indicate the need to educate primary care providers on treatment opportunities for individuals with vitiligo and that early treatment generally is more effective.5
Impact of Race/Ethnicity on Vitiligo Treatment—Our data also show trends for longer treatment delays for individuals with skin of color. Although this did not reach statistical significance, we hope future studies will investigate this issue, especially because patients with skin of color experience more stigmatization and quality-of-life impacts by vitiligo than White patients.5
Impact of BSA on Vitiligo Treatment—Our data show that patients with a smaller BSA had a shorter delay to treatment than those with a greater BSA affected. This was a unique finding given it initially was hypothesized that patients with greater BSA would seek treatment earlier because of the associated increase in quality of life impact. This trend was not statistically significant, but further investigation would be helpful to analyze the reason behind treatment delays in patients with greater BSA affected.
Conclusion
The delay to treatment in our study population was correlated with the diagnosing physician’s specialty and patient age at disease onset, with trends also observed for race and BSA affected. These findings emphasize the need to investigate specific causes of barriers to early care to promote health equity among individuals with vitiligo.
