Social determinants of health, quality of life, and productivity outcomes among adults with vitiligo in Brazil, China, India, and South Africa

Vitiligo is an autoimmune disease resulting in skin depigmentation and individuals report substantial psychosocial burden. However, vitiligo-related quality of life impacts appear heterogeneous and may be influenced by social determinants of health. This cross-sectional survey aimed to describe characteristics and vitiligo-related quality of life impacts among adults in Brazil, China, India, and South Africa. Results were stratified by country and examined by bivariate analysis. Respondents (n = 2202) were mean (standard deviation) 36.9 (11.5) years of age. The most frequently reported income quartile was the highest quartile in China, India, and South Africa, and second-lowest quartile in Brazil. Mean time since initial diagnosis was 11.7 years. Mean % body surface area with depigmentation ranged from 3.7% (China) to 9.7% (South Africa). Mean Dermatology Life Quality Index scores ranged from 5.8 in Brazil to 10.3 in India, indicating a 'moderate' effect of vitiligo on quality-of-life; for 32.3% of respondents, vitiligo had a 'very-to-extremely large' impact on quality-of-life. Mean daily activity impairment was 28.9%. Employed participants reported mean work impairment of 35.6%. Adults with vitiligo in Brazil, China, India, and South Africa reported diverse demographic, socioeconomic, and clinical characteristics. Overall, vitiligo had a moderate impact on quality of life and was associated with reduced work productivity and activity impairments.