Psychosomatic aspects of vitiligo. A review of the literature

Abstract

The active interest of researchers in the topic of vitiligo is due to both the potential for optimizing the treatment of chronic dermatosis of unknown etiology and the high psychosocial significance of the problem, which goes beyond the purely medical sphere.

The review deals with psychosomatic aspects of vitiligo: stressful manifestations; stigmatization and quality of life of patients with vitiligo; nosogenic (secondary) and comorbid vitiligo mental disorders; the article considers complex approaches to therapy, taking into account psychosomatic factors. The literature was searched in the following databases: PubMed, Scopus, MedLine, Embase, Cochrane, Russian State Library, the Sechenov Central Science Medical Library.

It seems extremely relevant and promising to develop a clinical typology of comorbid vitiligo psychosomatic disorders with the development of clinical recommendations for the identification, routing and therapy of an extensive contingent of patients with chronic dermatosis.

Keywords

vitiligo / psychosomatic disorders / stress manifestations / quality of life / stigmatization / nosogenic reactions / depression / social phobia

References

[1] Ezzedine K, Eleftheriadou V, Whitton M, van Geel N. Vitiligo. Lancet. 2015;386(9988):74–84. doi: 10.1016/S0140-6736(14)60763-7

[2] Ezzedine K., Eleftheriadou V., Whitton M., van Geel N. Vitiligo // Lancet. 2015. Vol. 386, N 9988. Р. 74–84. doi: 10.1016/S0140-6736(14)60763-7

[3] Katz EL, Harris JE. Translational research in Vitiligo. Front Immunol. 2021;(12):624517. doi: 10.3389/fimmu.2021.624517

[4] Katz E.L., Harris J.E. Translational research in vitiligo // Front Immunol. 2021. N 12. Р. 624517. doi: 10.3389/fimmu.2021.624517

[5] Picardo M, Dell’Anna ML, Ezzedine K, et al. Vitiligo. Nat Rev Dis Primers. 2015;(1):15011. doi: 10.1038/nrdp.2015.11

[6] Picardo M., Dell’Anna M.L., Ezzedine K., et al. Vitiligo // Nat Rev Dis Primers. 2015. N 1. Р. 15011. doi: 10.1038/nrdp.2015.11

[7] Rakhimov US, Mukhamadieva KM, Ismatulloeva SS. Neurovegetative disorders in vitiligo pathogenesis. Avicennas Bulletin. 2017;19(4):550–555. (In Russ). doi: 10.25005/2074-0581-2017-19-4-550-555

[8] Рахимов У.С., Мухамадиева К.М., Исматуллоева С.С. Нейровегетативные нарушения в патогенезе витилиго // Вестник Авиценны. 2017. Т. 19, № 4. С. 550–555. doi: 10.25005/2074-0581-2017-19-4-550-555

[9] Tang L, Li F, Xu F, et al. Prevalence of vitiligo and associated comorbidities in adults in Shanghai, China: A community-based, cross-sectional survey. Ann Palliat Med. 2021;10(7):8103–8111. doi: 10.21037/apm-21-1738

[10] Tang L., Li F., Xu F., et al. Prevalence of vitiligo and associated comorbidities in adults in Shanghai, China: A community-based, cross-sectional survey // Ann Palliat Med. 2021. Vol. 10, N 7. Р. 8103–8111. doi: 10.21037/apm-21-1738

[11] Frisoli ML, Essien K, Harris JE. Vitiligo: Mechanisms of pathogenesis and treatment. Annu Rev Immunol. 2020;(38):621–648. doi: 10.1146/annurev-immunol-100919-023531

[12] Frisoli M.L., Essien K., Harris J.E. Vitiligo: Mechanisms of pathogenesis and treatment // Annu Rev Immunol. 2020. N 38. Р. 621–648. doi: 10.1146/annurev-immunol-100919-023531

[13] Gürpınar A, Günaydın S, Kılıç C, Karaduman A. Association of serum cortisol and dehydroepiandrosterone sulfate (DHEAS) levels with psychological stress in patients with vitiligo. Turk J Med Sci. 2019;49(3):832–837. doi: 10.3906/sag-1812-84

[14] Gürpınar A., Günaydın S., Kılıç C., Karaduman A. Association of serum cortisol and dehydroepiandrosterone sulfate (DHEAS) levels with psychological stress in patients with vitiligo // Turk J Med Sci. 2019. Vol. 49, N 3. Р. 832–837. doi: 10.3906/sag-1812-84

[15] Ning X, Zhang Y, Wang W, et al. Evaluation of the behavioral and psychological symptoms in patients with vitiligo in China. Psychol Res Behav Manag. 2022;(15):2107–2116. doi: 10.2147/PRBM.S370445

[16] Ning X., Zhang Y., Wang W., et al. Evaluation of the behavioral and psychological symptoms in patients with vitiligo in China // Psychol Res Behav Manag. 2022. N 15. Р. 2107–2116. doi: 10.2147/PRBM.S370445

[17] Varzhapetyan AA, Dorozhenok IY, Lomonosov KM. Vitiligo and comorbid psychosomatic disordes. Russ J Skin Venereal Dis. 2019;22(1-2):33–38. (In Russ).

[18] Варжапетян А.А., Дороженок И.Ю., Ломоносов К.М. Витилиго и коморбидные психосоматические расстройства // Российский журнал кожных и венерических болезней. 2019. Т. 22, № 1-2. С. 33–38.

[19] Dahir AM, Thomsen SF. Comorbidities in vitiligo: Comprehensive review. Int J Dermatol. 2018;57(10):1157–1164. doi: 10.1111/ijd.14055

[20] Dahir A.M., Thomsen S.F. Comorbidities in vitiligo: Comprehensive review // Int J Dermatol. 2018. Vol. 57, N 10. Р. 1157–1164. doi: 10.1111/ijd.14055

[21] Bonotis K, Pantelis K, Karaoulanis S, et al. Investigation of factors associated with health-related quality of life and psychological distress in vitiligo. J Dtsch Dermatol Ges. 2016;14(1):45–49. doi: 10.1111/ddg.12729

[22] Bonotis K., Pantelis K., Karaoulanis S., et al. Investigation of factors associated with health-related quality of life and psychological distress in vitiligo // J Dtsch Dermatol Ges. 2016. Vol. 14, N 1. Р. 45–49. doi: 10.1111/ddg.12729

[23] Silverberg JI, Silverberg NB. Vitiligo disease triggers: Psychological stressors preceding the onset of disease. Cutis. 2015;95(5):255–262.

[24] Silverberg J.I., Silverberg N.B. Vitiligo disease triggers: Psychological stressors preceding the onset of disease // Cutis. 2015. Vol. 95, N 5. Р. 255–262.

[25] Morrison B, Burden-Teh E, Batchelor JM, et al. Quality of life in people with vitiligo: A systematic review and meta-analysis. Br J Dermatol. 2017;177(6):e338–339. doi: 10.1111/bjd.15933

[26] Morrison B., Burden-Teh E., Batchelor J.M., et al. Quality of life in people with vitiligo: A systematic review and meta-analysis // Br J Dermatol. 2017. Vol. 177, N 6. Р. e338–339. doi: 10.1111/bjd.15933

[27] Yang Y, Zapata L, Rodgers C, et al. Quality of life in patients with vitiligo using the short Form-36. Br J Dermatol. 2017;177(6):1764–1766. doi: 10.1111/bjd.15936

[28] Yang Y., Zapata L., Rodgers C., et al. Quality of life in patients with Vitiligo using the short Form-36 // Br J Dermatol. 2017. Vol. 177, N 6. Р. 1764–1766. doi: 10.1111/bjd.15936

[29] Ezzedine K, Eleftheriadou V, Jones H, et al. Psychosocial effects of vitiligo: A systematic literature review. Am J Clin Dermatol. 2021;22(6):757–774. doi: 10.1007/s40257-021-00631-6

[30] Ezzedine K., Eleftheriadou V., Jones H., et al. Psychosocial effects of vitiligo: A systematic literature review // Am J Clin Dermatol. 2021. Vol. 22, N 6. Р. 757–774. doi: 10.1007/s40257-021-00631-6

[31] Sangma LN, Nath J, Bhagabati D. Quality of life and psychological morbidity in vitiligo patients: A study in a teaching hospital from North-East India. Indian J Dermatol. 2015;60(2):142–146. doi: 10.4103/0019-5154.152508

[32] Sangma L.N., Nath J., Bhagabati D. Quality of life and psychological morbidity in vitiligo patients: A study in a teaching hospital from North-East India // Indian J Dermatol. 2015. Vol. 60, N 2. Р. 142–146. doi: 10.4103/0019-5154.152508

[33] Sarkar S, Sarkar T, Sarkar A, Das S. Vitiligo and psychiatric morbidity: A profile from a vitiligo clinic of a rural-based tertiary care center of eastern India. Indian J Dermatol. 2018;63(4):281–284.doi: 10.4103/ijd.IJD_142_18

[34] Sarkar S., Sarkar T., Sarkar A., Das S. Vitiligo and psychiatric morbidity: A profile from a vitiligo clinic of a rural-based tertiary care center of eastern India // Indian J Dermatol. 2018. Vol. 63, N 4. Р. 281–284. doi: 10.4103/ijd.IJD_142_18

[35] Osinubi O, Grainge MJ, Hong L, et al. The prevalence of psychological comorbidity in people with vitiligo: A systematic review and metaanalysis. Br J Dermatol. 2018;178(4):863–878. doi: 10.1111/bjd.16049

[36] Osinubi O., Grainge M.J., Hong L., et al. The prevalence of psychological comorbidity in people with vitiligo: A systematic review and metaanalysis // Br J Dermatol. 2018. Vol. 178, N 4. Р. 863–878. doi: 10.1111/bjd.16049

[37] Simons RE, Zevy DL, Jafferany M. Psychodermatology of vitiligo: Psychological impact and consequences. Dermatologic Therapy. 2020;33(3):e13418. doi: 10.1111/dth.13418

[38] Simons R.E., Zevy D.L., Jafferany M. Psychodermatology of vitiligo: Psychological impact and consequences // Dermatologic Therapy. 2020. Vol. 33, N 3. Р. e13418. doi: 10.1111/dth.13418

[39] Wang G, Qiu D, Yang H, Liu W. The prevalence and odds of depression in patients with vitiligo: A meta-analysis. J Eur Acad Dermatol Venereol. 2018;32(8):1343–1351. doi: 10.1111/jdv.14739

[40] Wang G., Qiu D., Yang H., Liu W. The prevalence and odds of depression in patients with vitiligo: A meta-analysis // J Eur Acad Dermatol Venereol. 2018. Vol. 32, N 8. Р. 1343–1351. doi: 10.1111/jdv.14739

[41] Kussainova A, Kassym L, Akhmetova A, et al. Vitiligo and anxiety: A systematic review and meta-analysis. PLoS One. 2020;15(11):e0241445. doi: 10.1371/journal.pone.0241445

[42] Kussainova A., Kassym L., Akhmetova A., et al. Vitiligo and anxiety: A systematic review and meta-analysis // PLoS One. 2020. Vol. 15, N 11. Р. e0241445. doi: 10.1371/journal.pone.0241445

[43] Khojah HM, Alharbi AG, Alshaeri AA, et al. Impact of narrow-band ultraviolet B radiation therapy on the quality of life of patients with vitiligo. J Taibah Univ Med Sci. 2021;16(6):843e848. doi: 10.1016/j.jtumed.2021.04.012

[44] Khojah H.M., Alharbi A.G., Alshaeri A.A., et al. Impact of narrow-band ultraviolet B radiation therapy on the quality of life of patients with vitiligo // J Taibah Univ Med Sci. 2021. Vol. 16, N 6. Р. 843e848. doi: 10.1016/j.jtumed.2021.04.012

[45] Cadmus SD, Riddle AO, Sebastian KR, et al. Psychosocial and quality-of-life factors associated with depigmentation therapy for vitiligo. Arch Dermatol Res. 2023;315(8):2283–2288. doi: 10.1007/s00403-023-02595-5

[46] Cadmus S.D., Riddle A.O., Sebastian K.R., et al. Psychosocial and quality-of-life factors associated with depigmentation therapy for vitiligo // Arch Dermatol Res. 2023. Vol. 315, N 8. Р. 2283–2288. doi: 10.1007/s00403-023-02595-5

[47] Al-Shobaili HA. Treatment of vitiligo patients by excimer laser improves patients’ quality of life. J Cutan Med Surg. 2015;19(1):50–56. doi: 10.2310/7750.2014.14002

[48] Al-Shobaili H.A. Treatment of vitiligo patients by excimer laser improves patients’ quality of life // J Cutan Med Surg. 2015. Vol. 19, N 1. Р. 50–56. doi: 10.2310/7750.2014.14002

[49] Olisova OY, Pinson IY, Myzina KA, Garanyan LG. Combined phototherapy method for vitiligo. Russ J Skin Venereal Dis. 2017;20(4):238–242. (In Russ). doi: 10.18821/1560-9588-2017-20-4-238-242

[50] Олисова О.Ю., Пинсон И.Я., Мызина К.А., Гаранян Л.Г. Комбинированный метод фототерапии витилиго // Российский журнал кожных и венерических болезней. 2017. Т. 20, № 4. С. 238–242. doi: 10.18821/1560-9588-2017-20-3-238-242

[51] Tavitova AR, Lomonosov KM. Comparative study of the effectiveness of combination therapy of vitiligo with methotrexate in combination with medium-wave narrow-band therapy UVB-311 nm and monotherapy UVB-311 nm. Russ J Skin Venereal Dis. 2021;24(5):451–459. (In Russ). doi: 10.17816/dv88864

[52] Тавитова А.Р., Ломоносов К.М. Сравнительное исследование эффективности комбинированной терапии витилиго метотрексатом в сочетании со средневолновой узкополосной терапией УФБ-311 нм и монотерапии УФБ-311 нм // Российский журнал кожных и венерических болезней. 2021. Т. 24, № 5. С. 451–459. doi: 10.17816/dv88864

[53] Cupertino F, Niemeyer-Corbellini JP, Ramos ES. Psychosomatic aspects of vitiligo. Clin Dermatol. 2017;35(3):292–297. doi: 10.1016/j.clindermatol.2017.01.001

[54] Cupertino F., Niemeyer-Corbellini J.P., Ramos E.S. Psychosomatic aspects of vitiligo // Clin Dermatol. 2017. Vol. 35, N 3. Р. 292–297. doi: 10.1016/j.clindermatol.2017.01.001

[55] Revankar RR, Revankar NR, Balogh EA, et al. Cognitive behavior therapy as dermatological treatment: A narrative review. Int J Womens Dermatol. 2022;8(4):e068. doi: 10.1097/JW9.0000000000000068

[56] Revankar R.R., Revankar N.R., Balogh E.A., et al. Cognitive behavior therapy as dermatological treatment: A narrative review // Int J Womens Dermatol. 2022. Vol. 8, N 4. Р. e068. doi: 10.1097/JW9.0000000000000068

[57] Rzepecki AK, McLellan BN, Elbuluk N. Beyond traditional treatment: The importance of psychosocial therapy in vitiligo. J Drugs Dermatol. 2018;17(6):688–691.

[58] Rzepecki A.K., McLellan B.N., Elbuluk N. Beyond traditional treatment: The importance of psychosocial therapy in vitiligo // J Drugs Dermatol. 2018. Vol. 17, N 6. Р. 688–691.

RIGHTS & PERMISSIONS

Eco-Vector