Vitiligo Care Personalized for Each Patient: Part 1

To better understand the complexities of treating a diverse range of patients with vitiligo, Dermatology Times gathered insights from 3 dermatologists: Rocco Serrao, MD, FAAD, of Dermatologists of Southwest Ohio in Dayton; Latanya Benjamin, MD, FAAD, dermatologist of Young Skin in Coral Springs, Florida; and Anthony Nuara, MD, PhD, of the Center for Dermatology & Plastic Surgery in Scottsdale, Arizona, who shared their experiences and patient cases in recent roundtable discussions. Their perspectives provide valuable insights into the challenges and advancements in managing vitiligo.

The Psychological Impact of Vitiligo

Serrao’s Perspective

Serrao initiated his discussion in Cleveland, Ohio, by emphasizing the importance of understanding the impact vitiligo has on patients. “With 0.5% to up to 2% of the population having vitiligo, it’s absolutely essential for clinicians to understand that we’re going to see individuals with this condition,” he said.¹ Serrao highlighted the varying degrees of psychological and social impacts vitiligo can have on patients, depending on their skin tone and personal circumstances.

Case Study: A Collegiate Athlete’s Struggle

Serrao shared a case of a 20-year-old man who is a collegiate athlete with segmental vitiligo. “He recently noticed these white patches on the right side of his face, and his brow was also turning white. He was very embarrassed by the appearance, affecting his self-confidence and interpersonal relationships,” Serrao recounted. This patient had not tried any treatments yet, highlighting a common issue—lack of awareness and access to effective therapies.

“Up to 60% of people with vitiligo believe there are no treatments available, which leads to a loss of hope. This is often due to health care providers not being aware of the therapies that are available,” Serrao said. This lack of awareness among both patients and providers can hinder effective management of the condition.

Personalized Treatment Plans

Serrao emphasized the need for personalized treatment plans. He explained the approaches for segmental and non-segmental vitiligo, stressing the importance of patient-specific strategies. “We need to sit down and have a discussion with each individual to understand how the disease is affecting them because it can affect everyone differently,” he advised. This individualized approach is crucial for achieving the best outcomes for patients.

Serrao also provided insights on the role of phototherapy, a common treatment for vitiligo. “Narrowband UV-B phototherapy is often considered the gold standard for vitiligo treatment, especially for extensive disease. It can help repigment the skin over time, but it requires consistent and long-term commitment from the patient,” he explained. He and the roundtable participants highlighted the importance of setting realistic expectations with patients regarding the duration and consistency of treatment.

Reference

1. Joge RR, Kathane PU, Joshi SH. Vitiligo: a narrative review. Cureus. 2022;14(9):e29307. Published 2022 Sep 18. doi:10.7759/cureus.29307

Read part 2 featuring Latanya Benjamin, MD, FAAD