Vitiligo patient population and disease burden in France: VIOLIN study results from the CONSTANCES cohort

Abstract Background Vitiligo is a chronic autoimmune disease resulting in skin depigmentation. Objectives This study assessed the prevalence, disease burden and treatment of vitiligo in France. Methods VIOLIN was a cross‐sectional study nested in the national CONSTANCES cohort, which consists of randomly selected adults aged 18–69 years in France. In VIOLIN, longitudinal data were collected prospectively from 158,898 participants during 2012–2018 and linked to the National Health Data System (SNDS), a healthcare utilization database. Patients with physician‐diagnosed vitiligo were matched (1:3) with control participants based on age, sex, geographic region, year of inclusion and skin phototype. Patients completed a questionnaire in 2022 to collect disease characteristics, disease burden and quality‐of‐life (QoL) data. Results Vitiligo prevalence was 0.71% (681/95,597) in 2018. The mean age in the vitiligo population was 51.2 years; 51.4% were women. Most patients (63%) were diagnosed before age 30 years, mainly by dermatologists (83.5%). Most patients (81.1%) had visible lesions (i.e. on face, hands). Vitiligo was limited to <10% of the body surface area (BSA) in 85.8% of patients. Comorbidities including thyroid disease (18.0% vs. 9.0%), psoriasis (13.7% vs. 9.7%), atopic dermatitis (12.4% vs. 10.3%), depression (18.2% vs. 14.6%) and alopecia areata (4.3% vs. 2.4%) were significantly more common in patients with vitiligo versus matched controls ( n = 2043). QoL was significantly impaired in patients with >5% BSA involvement or visible lesions, particularly with ≥10% facial involvement. Vitiligo‐specific instruments (i.e. Vitiligo Impact Patient scale and Vitiligo‐specific QoL instrument) were more sensitive to QoL differences among subgroups versus general skin instruments, and generic instruments were least sensitive. Most patients (83.8%) did not receive any prescribed treatment. Conclusions Patients with vitiligo in France have a high disease burden, particularly those with visible lesions or higher BSA involvement. Most patients are not receiving treatment, highlighting the need for new effective treatments and patient/physician education.