Post-Traumatic Stress in Vitiligo Patients: A Neglected but Real-Existing Psychological Impairment

Figures & data

Table 1 Basic Information of the Included Patients

Variables	Values
Age (Years, Mean±SD)	30.0±11.4
Female (n, %)	202 (59.9)
Education≥universities (n, %)	164(48.7)
Work in Urban (n, %)	225(66.8)
Smoking (n, %)	32(9.5)
Alcohol (n, %)	57(16.1)
Duration of vitiligo<1 years (n, %)	32 (9.5)
VASI<1% (n, %)	228 (67.66)
DLQI (Mean±SD)	9.7±6.3
Disease location
Face and neck (n, %)	167 (49.6)
Foot and hand (n, %)	155(46.0)
Scalp (n, %)	81 (24.0)
Trunk (n, %)	129(38.3)
Limb (n, %)	51 (15.1)
Genital area (n, %)	90 (26.7)
Presence of PTS/PTSD
PTS (n, %)	102(30.3)
PTSD (n, %)	42(12.5)
Progress of vitiligo
Progression (n, %)	170 (50.5)
Stability/Regression (n, %)	167 (49.5)
Treatments
Oral glucocorticoid (n, %)	45(13.4)
Glycyrrhiza (n, %)	220(65.3)
External steroid/calcineurin inhibitors (n, %)	240 (71.2)
Masking agent (n, %)	26 (7.7)
External photochemical sensitizer (n, %)	20 (5.9)
UVB Phototherapy (n, %)	128 (38.0)
Surgical intervention (n, %)	15 (4.3)
Comorbidity
Cardiovascular disease (n, %)	6 (1.8)
Diabetes mellitus (n, %)	7 (2.1)
Thyroid disease (n, %)	43 (12.8)
Asthma (n, %)	2 (1.0)
Chronic urticaria (n, %)	7 (2.1)
Depression (n, %)	8 (2.4)

Abbreviations: SD, standard deviation; VASI, vitiligo area scoring index; DLQI, dermatology life quality index; PTS, post-traumatic stress; PTSD, post-traumatic stress disorder.

Table 2 PTS and PTSD in Patients with Vitiligo

	PTS			PTSD
	No	Yes	P value	No	Yes	P value
	N=235	N=102		N=295	N=42
Demographic information
Age≥30 years (Years, Mean±SD)	108(45.96)	42(41.18)	0.417	135(45.76)	15(35.71)	0.220
Female (n, %)	139(59.15)	63(61.76)	0.653	178(60.34)	24(57.14)	0.692
Education≥universities (n, %)	128(54.47)	36(35.29)	0.001*	152(51.53)	12(28.57)	0.005*
Work in Urban (n, %)	156(66.38)	69(67.65)	0.821	195(66.10)	30(71.43)	0.493
Smoking (n, %)	20(8.51)	12(11.76)	0.349	23(7.80)	9(21.43)	0.005*
Alcohol (n, %)	39(16.60)	18(17.65)	0.813	48(16.27)	9(21.43)	0.404
PTS or PTSD related variables
PCL-C (mean±SD)	27.77±5.96	51.88±12.62	0.000*	30.90±8.29	64.36±10.29	0.000*
Psychotherapy (n, %)	7 (2.98)	6(5.88)	0.335	8(2.71)	5(11.90)	0.014*
Medication (n, %)	5 (2.13)	4(3.92)	0.568	6(2.03)	3(7.14)	0.159
Both (n, %)	5 (2.13)	4(3.92)	0.568	6(2.03)	3(7.14)	0.159
Vitiligo-related variables
Duration<1 years (n, %)	14(5.96)	18(17.65)	0.001*	26(8.81)	6(14.29)	0.258
VASI<1%, (n, %)	171(72.77)	57(55.88)	0.002*	204(69.15)	24(57.14)	0.120
Vitiligo site
Face and neck (n, %)	102(43.40)	65(63.73)	0.001*	138(46.78)	29(69.05)	0.007*
Feet and hands (n, %)	98(41.70)	57(55.88)	0.016*	125(42.37)	30(71.43)	0.000*
Trunk (n, %)	88(37.45)	41(40.20)	0.633	109(36.95)	20(47.62)	0.183
Limb (n, %)	27(11.49)	24(23.53)	0.005*	39(13.22)	12(28.57)	0.009*
Scalp (n, %)	51(21.70)	30(29.41)	0.128	63(21.36)	18(42.86)	0.002*
Genital area (n, %)	57(24.26)	33(32.35)	0.123	75(25.42)	15(35.71)	0.158
Progress of vitiligo
Progression (n, %)	116(49.36)	54(52.94)	0.546	149(50.51)	21(50.00)	0.951
Stability/Regression (n, %)	119(50.64)	48(47.06)		146(49.49)	21(50.00)
Treatments
Oral glucocorticoid (n, %)	33(14.04)	12(11.76)	0.572	36(12.20)	9(21.43)	0.100
Glycyrrhiza (n, %)	157(66.81)	63(61.76)	0.372	190(64.41)	30(71.43)	0.371
External steroid/calcineurin inhibitors (n, %)	165(70.2)	75(73.5)	0.537	210(71.19)	30(71.43)	0.974
Masking agent (n, %)	5(2.13)	21(20.59)	0.000*	20(6.78)	6(14.29)	0.088
External photochemical sensitizer (n, %)	17(7.23)	3(2.94)	0.125	17(5.76)	3(7.14)	0.723
UVB Phototherapy (n, %)	86(36.60)	42(41.18)	0.426	107(36.27)	21(50.00)	0.086
Surgical intervention (n, %)	5(2.13)	10(9.80)	0.002*	7(2.37)	8(19.05)	0.000*
Comorbidity
Cardiovascular disease (n, %)	3(1.28)	3(2.94)	0.288	6(2.03)	0(0.00)	0.351
Diabetes mellitus (n, %)	4(0.00)	3(5.88)	0.751	6(2.03)	1(2.38)	0.883
Thyroid disease (n, %)	28(11.91)	15(14.71)	0.48	37(12.54)	6(14.29)	0.751
Asthma (n, %)	2(0.01)	0(0.00)	0.875	2(0.01)	0(0.00)	0.590
Chronic urticaria (n, %)	5(0.02)	2(0.02)	0.751	6(0.02)	1(0.02)	0.067
Depression (n, %)	5(2.13)	3(2.94)	0.652	5(1.69)	3(7.14)	0.030*

Note: *Statistically significant difference between groups.

Abbreviations: SD, standard deviation; PTS, post-traumatic stress; PTSD, post-traumatic stress disorder; VASI, vitiligo area scoring index.

Figure 1 Percentage of vitiligo patients selecting “moderate” or “greater” in individual items of the PCL-C.