Clinical Severity and Quality of Life Impairment in Vitiligo: A Literature Review on the Relationship Between VASI and DLQI

Abstract

Vitiligo poses a long term challenge that affects not just physical appearance but also emotional health and daily life. People living with the condition often face difficulties related to the visibility of skin changes, the unpredictable nature of the disease, and how others in society respond to it, all of which significantly affect their overall quality of life. Recent research highlights the importance of understanding the impact of vitiligo through both medical and personal accounts. Two commonly used tools, the Vitiligo Area Scoring Index (VASI) and the Dermatology Life Quality Index (DLQI), provide different but complementary views on how the loss of skin color relates to emotional and social effects. This review brings together findings from recent studies to explore how these measures connect and what they reveal about the lived experience of vitiligo. VASI measures the size and spread of depigmented patches, while DLQI looks at how these changes affect emotions, social relationships, work, and self esteem. Research across various settings consistently shows that more severe disease is linked to greater impairment in quality of life, although the strength of this link can vary based on factors like age, how long someone has had the condition, the level of stigma they face, and cultural background. The available evidence suggests that using both VASI and DLQI together gives a more complete understanding of the burden of vitiligo than using either one alone, highlighting the importance of considering both visible and hidden aspects of the condition. New studies also suggest that psychological support, early counseling, and tailored treatment plans may help reduce the difference between the severity of the disease as seen by doctors and how much distress it causes the individual. By combining insights from dermatology, psychology, and patient reported outcomes, this review emphasizes the value of using a multidimensional approach in vitiligo care. Future research should use long term and culturally diverse methods to better understand how disease severity and perceptions of quality of life change over time, and to improve interventions that support the overall well being of people with vitiligo.