Patients' testimonies, feelings, complaints and emotional experiences with dermatoses on open social media: The French infodemiologic patient's free speech study.

BACKGROUND: Dermatoses represent a significant burden. Patients and their caregivers can turn to social media and digital communities to exchange with each other. These public exchanges constitute real-life data that can be analysed to better understand the patients' feelings and expectations, and the daily difficulties encountered. OBJECTIVE: An infodemiologic study of public testimonies of patients and caregivers related to five dermatoses: eczema, rosacea, vitiligo, acne and psoriasis, over a 3-year time frame (September 2018 to September 2021) in France. To identify main topics of discussion, encountered difficulties and unmet medical needs. METHODS: Data extraction was performed based on a list of pertinent keywords. Web-users' profiles were determined by a specifically trained machine learning algorithm. Encountered difficulties were identified by manual annotation based on a standardized search grid. Co-occurrence analysis of difficulties allowed contextualization of challenges and unmet needs for each dermatosis. RESULTS: A total of 20,282 messages coming from 16,800 web users was extracted. The main topics of discussion were 'Impact on self- image and self-confidence' (23.6%), 'Generic discussion about therapeutics' (23.3%) and 'Burden of others' gaze' (12.8%). The top three mentioned difficulties for the five targeted dermatoses were similar and focused on 'Fear of/and management of symptoms', 'Impact on/and mood management' and 'Damaged self-image'. CONCLUSION: This infodemiologic study highlighted the real-life management of five skin diseases by patients and their caregivers, who turned to social networks to openly express their suffering and seek solutions. The joined analysis of the five diseases enabled a common comprehension of what it is to live with a skin disease, from a patient-centric point of view. The specific analysis of each patient group objectified specific challenges, and main unmet medical needs.

Vitiligo: an update on systemic treatments.

Vitiligo is an autoimmune skin condition characterized by depigmented macules and patches, and has a huge psychosocial impact on patients. Treatment of vitiligo aims to prevent the spread of disease and facilitate repigmentation of affected lesions. The mainstay of treatment for unstable vitiligo has been topical agents (corticosteroids, calcineurin inhibitors) and phototherapy. However, systemic treatments are increasingly being shown to have a significant impact on the course of the disease as monotherapy or adjunctive therapy. Of note, oral mini-pulsed corticosteroid therapy, methotrexate, minocycline, ciclosporin, Janus kinase inhibitors and certain supplements have been used in the systemic treatment of vitiligo. We review the underlying evidence supporting the use of each of these systemic treatments.

The stigma of skin disease.

PURPOSE OF REVIEW: The effects of skin disease on stigmatization are important but understudied in the pediatric population. Given the highly visible nature of dermatologic conditions, stigmatization is a common problem that requires significant attention in patients with skin diseases. In this review, we examine the recent literature addressing stigmatization of patients suffering from common dermatologic diseases with the goal to increase clinician awareness of these issues and identify new avenues for future research. RECENT FINDINGS: A number of studies have examined the impact of skin disease on psychosocial well being and quality of life. Although some skin diseases are often overlooked medically and considered to be primarily cosmetic issues, the long-term consequences of skin diseases on psychosocial health, especially in pediatric patients, can be profound. SUMMARY: The precipitating factors for stigma vary widely depending on age, sex, and culture. In order to effectively reduce the impact of pediatric skin diseases on psychosocial health, physicians should be able to identify specific characteristics that may increase risks for stigmatization in chidlren. Carefully monitoring psychosocial development in pediatric patients with dermatological conditions in addition to proactively guiding patients and families to appropriate resources can benefit the child's development and overall long-term well being.

Disorders of Hypopigmentation

Hypopigmentation and depigmentation of the skin can be due to multiple causes and has a broad differential diagnosis. The most common cause of depigmentation worldwide is vitiligo. This disorder affects 1-2% of the world's population and is seen in all races. Vitiligo is an autoimmune disorder in which the predominant cause is an attack by CD8+ cytotoxic T cells on melanocytes in the epidermis. This condition can have a significant negative impact on the quality of life of affected individuals. Treatment options currently include psychological counseling, topical therapy, systemic therapy, phototherapy, surgical therapy, and depigmentation. In patients with stable, refractory disease, successful repigmentation has been achieved using mini-punch grafting, blister grafting, and non-cultured epidermal suspension (NCES) grafting. Emerging therapies include the Janus kinase (JAK) inhibitors ruxolitinib and tofacitinib. Further studies exploring the pathogenesis of vitiligo are warranted in order to optimize treatment for affected patients. J Drugs Dermatol. 2019;18(3 Suppl):s115-116.

The color of skin: psychiatric ramifications.

Skin color is one of the major attributes that defines both individual distinctiveness and differences between groups. There is a preference for lighter skin world-wide, among both light- and dark-skinned individuals, further leading to skin-color bias based upon skin-color hierarchy within certain ethnoracial groups. The psychiatric and psychosocial ramifications of skin color are important in several situations, including (1) disorders of skin discoloration (eg, vitiligo), which can significantly affect the psychosocial development of the patient especially when it has its first onset during adolescence; (2) widespread use of skin-lightening products, which are used despite knowledge about serious toxicity from inorganic mercury and potent corticosteroids that are some of their main constituents; (3) indoor tanning, which is a recognized carcinogen and practiced by over 50% of university-age adults and 20% of adolescents. Educating about photocarcinogenicity does not change tanning behaviors, which is strongly driven by peer pressure; and (4) when a psychiatric disorder, such as body dysmorphic disorder or major depressive disorder, is the primary basis for skin color dissatisfaction. Despite the role of complex sociocultural and psychiatric factors in clinical manifestations involving skin color, a supportive relation with the dermatologist can significantly aid the patient in managing their disease burden.

Patrón cutáneo pigmentario de disposición lineal en un niño, vitíligo segmentario vs. hipomelanosis de Ito / Linear disposition pigmentary skin pattern in a child, segmental vitiligo vs. Hypomelanosis of Ito

Introducción: algunas enfermedades dermatológicas siguen disposición con patrones lineales. Con hipopigmentación en la infancia se encuentran el vitíligo segmentario, que sigue los dermatomas, aunque puede seguir las líneas de Blaschko y la hipomelanosis de Ito, que a su vez sigue las líneas de Blaschko. Estas dermatosis son infrecuentes en la práctica dermatólogica. Objetivo: profundizar en los elementos diagnósticos que permiten diferenciar dos dermatosis clínicamente caracterizadas por hipopigmentación segmentaria lineal de tipo blaschkoide y el tratamiento. Presentación del caso: a la consulta de Genodermatosis en Las Tunas acude un niño con máculas acrómicas en hemicuerpo izquierdo, sin otras alteraciones. Después de ser evaluado por varias especialidades (Dermatología, Genética, Pediatría, Oftalmología y Neurología), se determina que solo presentaba afectación cutánea, se le realizó biopsia de piel, que corroboró el diagnóstico de vitíligo segmentario. Conclusiones: se presenta el caso porque el vitíligo segmentario es infrecuente, sigue un patrón lineal que puede ser diferenciado de otra dermatosis infrecuente, como la hipomelanosis de Ito, y en el tratamiento es importante brindar apoyo psicológico al paciente para favorecer la obtención de mejores resultados con la Melagenina Plus(AU)

Introduction: some dermatological diseases are still available with linear patterns. In childhood with hypopigmentation can be found segmental vitiligo (which follows the dermatomes although it can follow the lines of Blaschko), and Hypomelanosis of Ito (which in turn follows the lines of Blaschko). These dermatoses are infrequent in dermatological practice. Objective: to deepen into the diagnostic elements that allows the differentiation of two dermatoses clinically characterized by linear segmental hypopigmentation of blaschkoid type and treatment. Case presentation: a child attends to the consultation of Genodermatoses in Las Tunas presenting acromic macules in left half of the body, without other alterations. After being evaluated by several specialties (Dermatology, Genetics, Pediatrics, Ophthalmology and Neurology), it was determined that only skin affectation was present. A skin biopsy was performed, which corroborated the diagnosis of segmental vitiligo. Conclusions: The case is presented because segmental vitiligo is infrequent, it follows a linear pattern that can be differentiated from another uncommon dermatosis, such as Hypomelanosis of Ito, and in the treatment it is important to provide psychological support to the patient to favor obtaining better results with Melagenina Plus(AU)

Vitiligo as a psychosocial disease: apprehensions of patients imprinted by the white / O vitiligo como uma doença psicossocial: apreensões de pacientes marcados pelo branco / El vitíligo como una enfermedad psicosocial: comprensión de pacientes marcados por lo blanco

This study aimed to show the comprehension that patients bearing vitiligo have over their condition, also assessing the association with their health and disease concepts. It is a qualitative research with descriptive and exploratory purposes, carried out from an epidemiological survey throughout the years of 2010-2013, with records from a dermatology outpatient care sector of a seminal hospital located in the city of Campina Grande - Paraíba, Brazil. It was identified that from the 832 existing records, 13 were of vitiligo patients and, from them, eight agreed to be part of this study, answering a semi-structured questionnaire. Data examination was made using the Thematic Content Analysis technique, identifying four categories. Results indicated that the process of being stricken with the disease is directly related to social practices that target the "stained" subject, over whom vitiligo has imprinted its patches.(AU)

O presente estudo teve por objetivo apresentar a compreensão de sujeitos portadores de vitiligo sobre sua afecção, avaliando também a associação com a concepção de saúde-doença. Trata-se de uma pesquisa qualitativa de caráter descritivo e exploratório, realizada a partir de um levantamento epidemiológico do período de 2010-2013, em prontuários do ambulatório de dermatologia de um hospital de referência localizado na cidade de Campina Grande - Paraíba, Brasil. Identificou-se que de 832 prontuários existentes, 13 pacientes possuíam vitiligo e, destes, apenas oito aceitaram participar do estudo, respondendo a um questionário semiestruturado. O tratamento dos dados ocorreu por meio da técnica de análise de conteúdo temática, identificando quatro categorias. Os resultados indicaram que o processo de adoecimento está diretamente ligado às práticas sociais que são direcionadas ao sujeito "manchado", sobre o qual o vitiligo imprimiu suas marcas.(AU)

El objetivo de este estudio fue presentar la comprensión de sujetos portadores de vitíligo sobre su afección, evaluando también la asociación con el concepto de salud-enfermedad. Se trata de una investigación cualitativa de carácter descriptivo y exploratorio, realizada a partir de un levantamiento epidemiológico del período de 2010-2013, en fichas del ambulatorio de dermatología de un hospital de referencia localizado en la ciudad de Campina Grande - estado de Paraíba, Brasil. Se identificó que, de las 832 fichas existentes, 13 pacientes sufrían de vitíligo y de ellos solamente ocho aceptaron participar en el estudio, respondiendo un cuestionario semi-estructurado. El tratamiento de los datos se realizó por medio de la técnica de análisis de contenido temático, identificando cuatro categorías. Los resultados indicaron que el proceso de enfermedad está directamente vinculado a las prácticas sociales que se dirigen al sujeto "manchado", sobre el cual el vitíligo imprimió sus marcas.(AU)

"Mata de tristeza!&": representações sociais de pessoas com vitiligo atendidas na Farmácia Universitária da Universidade Federal do Rio de Janeiro, Brasil / "Sadness kills!": Social representations of people who have vitiligo assisted in the pharmacy of the Federal University of Rio de Janeiro, Brazil / "Mata de tristeza!": representaciones sociales de personas que tienen vitiligo y son atendidas en la Farmacia Universitaria de la Universidade Federal do Rio de Janeiro, Brasil

Vitiligo é caracterizado por manchas brancas na pele. Na dispensação do metoxisaleno utilizado para tratá-lo, na Farmácia Universitária/UFRJ, os portadores relatavam mal-estares devido à terapia e à doença. A busca pela compreensão da experiência do adoecer conduziu este estudo que adota perspectiva teórico-metodológica socioantropológica. A apreensão da visão de mundo dos sujeitos foi captada em entrevistas entre usuários da FU/UFRJ. A partir do diagnóstico, os sujeitos consideram o vitiligo "um castigo" sentem-se alvo de "chacotas", "preconceito", "discriminações". A experiência da doença impõe rever seus conceitos e filiação religiosa. O fato de o vitiligo não ser concebido como doença grave estabelece um não-lugar para o sofrimento dos portadores. Aspectos simbólicos, emocionais e socioculturais que circunscrevem a doença devem ser considerados para melhorar a atenção à saúde e vida desses sujeitos. Os profissionais de saúde precisam concebê-los para além de suas "manchas".

Vitiligo is characterized by white spots on the skin. During the dispensation of Methoxypsoralen, a drug used for treating it, patients reported discomfort regarding such therapy and their disease. Thus, the study has the motivation of seeking to understand the experience of being ill, using a socio-anthropological, theoretical and methodological approach. Subjects' worldview after the diagnosis of vitiligo was apprehended by interviews with UFRJ pharmacy users. The subjects tend to consider having vitiligo "punishment", and they feel like a target of "mockery", "prejudice" and "discrimination". It is a fact that vitiligo is not taken as a severe condition, and this establishes a "non-place" for the suffering of its bearers. Symbolic, emotional, and socio-cultural aspects of the disease must be taken into account, in order to improve health care for these subjects and their lives. Health professionals need to perceive vitiligo bearers beyond their "spots".

El vitiligo se caracteriza por manchas blancas en la piel. En el momento de la entrega del medicamento correspondiente a esta enfermedad en la farmacia, los pacientes nos informaron sobre incomodidades por que pasaron. La incomodidad en la cosmovisión de los sujetos fue capturada en entrevistas. A partir del diagnóstico médico, los sujetos comenzaron a considerar al vitiligo como "un castigo", blanco de "burlas", 'prejuicios" y "discriminación". Así mismo, la experiencia de la enfermedad les condujo a revisar sus conceptos y religiones. El hecho de que el vitiligo no se considera una enfermedad graveparece establecer un "no lugar" para el sufrimiento y el "dolor espiritual" de sus portadores. Los aspectos simbólicos, emocionales y socioculturales que circunscriben esta enfermedad deben considerarse para mejorar la atención de la salud y la vida de estos sujetos. Por su parte, los profesionales de la salud deben aprender a concebirlos más allá de sus "manchas".

Knowledge, beliefs, and perceptions of Turkish vitiligo patients regarding their condition

Abstract BACKGROUND: Vitiligo is an acquired pigmentary skin disorder that affects 0.5% to 2.0% of the population. OBJECTIVE: Patients' knowledge, opinions, and attitudes about vitiligo were evaluated. METHODS: The team conducted a cross-sectional, descriptive, prospective study between June 2014 and May 2015. The study included 100 patients aged over 12 years who were diagnosed with vitiligo. A questionnaire including items on knowledge, opinions, and beliefs about vitiligo and the Illness Perception Questionnaire (IPQ) were filled out by the patients, and the results were analyzed. RESULTS: In total, 100 (58 female, 42 male) patients were included in the study. Of them, 74% knew the name of their disease, 90% thought that vitiligo was not contagious, 48% reported that they obtained information on the disease from a doctor, and 69% believed they had adequate information on vitiligo. Eighty percent reported no negative effects from vitiligo on relationships with friends or family. It was believed that stress, excessive sun exposure, and heredity were causes of vitiligo, according to 84%, 37%, and 22% of the patients, respectively. Thirty-six patients (36%) believed that their illness was a serious disease and 35% deemed that it did not have a major impact on their lives. CONCLUSIONS: Our results show that vitiligo patients were generally highly aware of their condition. The disease did not negatively affect patient opinions or attitudes about vitiligo. The authors believe that improving patient-physician communication will impact positively on the course of the disease.

[Vitiligo: Clinical presentation and pathogenesis]. / Vitiligo : Klinik und Pathogenese.

BACKGROUND: Vitiligo is a chronic skin disorder with depigmentation of circumscribed areas due to structural and functional damage to melanocytes. RESULTS: There is international consensus on the classification in nonsegmental and segmental vitiligo. The influence of vitiligo on the quality of life is significant and is influenced by ethnic and sociocultural factors. There is a new insight into the genetic susceptibility, mechanisms and targets of the autoimmune inflammation, the altered morphology and function of melanocytes and into the association of vitiligo with other autoimmune diseases, skin cancer and skin cancer therapy. CONCLUSIONS: The recognition of associated autoimmune disorders is as important as is the assessment of changes in the quality of life. New insight into the pathogenesis may have therapeutic consequences. The relationship between vitiligo and skin cancer and between vitiligo and immunotherapies in patients with metastatic melanoma warrants close clinical monitoring of affected patients and further scientific studies.

Impact of Cosmetic Camouflage on the Quality of Life of Children With Skin Disease and Their Families.

BACKGROUND/OBJECTIVES: Cosmetic camouflage is known to improve quality of life in adults. Few data are available regarding cosmetic camouflage in children, and thus it is not often selected as a mode of treatment. We sought to determine whether cosmetic camouflage leads to improved quality of life of pediatric patients with visible dermatoses and their parent or primary caregiver. METHODS: Patients aged 5 to 17 years with visible skin disease and their parent were assessed with the Children's Dermatology Life Quality Index (CDLQI) and the Family Dermatology Life Quality Index (FDLQI) before and after consultation regarding cosmetic camouflage. RESULTS: Twenty-two children with skin conditions were included in the study. The mean CDLQI decreased from 6.82 (SD = 1.28) to 3.05 (SD = 0.65; P = .0014), while the mean FDLQI decreased from 7.68 (SD = 1.15) to 4.68 (SD = 0.92; P = .0012). CONCLUSIONS: Our study highlighted improvement in quality of life in patients with skin disorders who were managed with cosmetic camouflage.

Psicodermatología en la atención primaria / Psychodermatology in primary care

The skin has the distinction of being the largest, visible and accessible part of the human body, and it hides a close and old relationship with the human psyche, and so has been demonstrated in the last years, where more elements of the Mental Health are elucidated playing a role in the pathogenesis of skin diseases, as well as there are some descriptions of the inverse relationship, this is, on how the skin diseases affect Mental Health of the individual. In this paper we propose to emphasize the importance of the issue, to consider a comprehensive approach to everyday Dermatology in Primary Care Medicine.

Vitiligo disease triggers: psychological stressors preceding the onset of disease.

Vitiligo is the loss of skin pigmentation caused by autoimmune destruction of melanocytes. Little is known about the impact of psychological stressors preceding vitiligo onset on symptoms associated with vitiligo and the extent of disease. We performed a questionnaire-based study of 1541 adults with vitiligo to evaluate the impact of psychological stressors in this patient population. Psychological stressors should be considered as potential disease triggers in vitiligo patients, and screening of vitiligo patients for psychological stressors and associated symptoms should be included in routine assessment.

Translation, cross-cultural adaptation and validation of the vitiligo-specifi c health-related quality of life instrument (VitiQoL) into Brazilian Portuguese

Abstract BACKGROUND: Vitiligo, although asymptomatic, highly compromises patients' quality of life (QoL). Therefore, an adequate evaluation of QoL is essential. OBJECTIVES: Translation, cultural adaptation and validation of VitiQol (Vitiligo-specific health-related quality of life instrument) into Brazilian Portuguese. METHODS: The study was conducted in two stages; the first stage was the translation and cultural/linguistic adaptation of the instrument; the second stage was the instrument's validation. RESULTS: The translated VitiQol showed high internal consistency (Cronbach alpha = 0.944) and high test-retest reliability and intraclass correlation coefficient=0.95 (CI 95% 0.86 - 0.98), p<0.001. There was no statistically significant difference between the means of the first completion of the VitiQoL questionnaire and the retest, p = 0.661. There was a significant correlation between VitiQoL and DLQI (r = 0.776, p <0.001) and also between VitiQoL-PB and subjects' assessment of the severity of their disease (r = 0.702, p <0.001). CONCLUSIONS: The impact of vitiligo on the QoL of Brazilian patients can be assessed by a specific questionnaire. .

Perfil clínico e epidemiológico do vitiligo infantil: análise de 113 casos diagnosticados em um centro de referência em dermatologia de 2004 a 2014 / Clinical and epidemiological profile of childhood vitiligo: analysis of 113 cases diagnosed at a dermatology referral center from 2004 to 2014

Introdução: O vitiligo é forma adquirida autoimune de hipopigmentação ou despigmentação, iniciando-se na infância metade de seus casos. Objetivos: Traçar o perfil clínico e epidemiológico do vitiligo infantil em um centro de referência em dermatologia. Métodos: Estudo transversal e descritivo com análise dos prontuários de pacientes com menos de 13 anos diagnosticados como portadores de vitiligo entre 2004 e 2014. Resultados: Dos 113 casos identificados, 54% eram do sexo feminino e 46% do sexo masculino; a idade variou de zero a 12 anos com a maioria dos pacientes (54,8%) no subgrupo de quatro a oito anos. Em 59% dos prontuários não havia registro sobre fatores desencadeantes do vitiligo; 31% dos pacientes associaram o início da doença a estresse emocional, 3% a trauma físico, e 7% não associaram a fator desencadeante. Conclusões: A discreta prevalência no sexo feminino também foi descrita em outros estudos. O comportamento do vitiligo na criança é diferente daquele observado nos adultos. A influência dos fatores psicológicos como desencadeantes e os potenciais efeitos duradouros na autoestima devem ser levados em consideração na abordagem do paciente. Os resultados deste trabalho foram semelhantes aos relatos existentes sobre o vitiligo nessa faixa etária, que são, aliás, poucos na literatura

Introduction: Vitiligo is an acquired autoimmune form of hypopigmentation or depigmentation in which half of the cases begins in childhood. Objectives: To describe the clinical and epidemiological profile of childhood vitiligo in a referral center for dermatology. Methods: A cross-sectional, descriptive study was carried out based on the analysis of medical records of patients younger than 13 years diagnosed with vitiligo from 2004 to 2014. Results: Of the 113 cases identified, 54% were female and 46% male, the age ranged from 0 to 12 years, with most patients in the 4-8 years-old subgroup (54.8%). In 59% of the medical records there was no record of triggering factors of vitiligo; 31% of patients associated the onset of the illness to emotional stress, 3% to physical trauma and 7% did not associate it to any triggering factor. Conclusions: The discreet prevalence in women has also been reported in other studies. Vitiligo behavior in children is different from that observed in adults. The influence of psychological factors as triggers and potential lasting effects on self-esteem should be considered in the approach of the patient. Although studies on vitiligo in this age group are scarce in the literature, the results of the present study were similar to the reports already available in the literature

Correlation of clinical efficacy and psychosocial impact on vitiligo patients by excimer laser treatment.

BACKGROUND AND OBJECTIVES: Vitiligo is a difficult disease to treat. Recently, a 308-nm excimer laser has been shown to be effective in treating vitiligo. In addition, the patients with vitiligo have impairment in their quality of life. The aim of the study was to investigate the clinical efficacy, safety, and psychosocial impact after treating vitiligo with the 308-nm excimer laser. DESIGN AND SETTINGS: A prospective clinical trial conducted at dermatology clinics of hospitals affiliated with Qassim University, Saudi Arabia, from May 2012 to February 2013. PATIENTS AND METHODS: Forty-eight patients with 105 vitiliginous patches were treated using a 308-nm excimer laser. The treatment was performed twice per week for a maximum of 48 treatments or 100% repigmentation of lesions whichever was achieved first. The assessment of the clinical response and recording of side effects were performed biweekly. RESULTS: Out of 105 lesions in these patients, 63 lesions (60.0%) achieved over 75% repigmentation by laser treatment, 12 lesions (11.4%) showed 51% to 75% repigmentation, 9 lesions (8.6%) showed 26% to 50% repigmentation, and another 9 lesions (8.6%) showed 1% to 25% repigmentation, while 12 lesions (11.4%) showed no repigmentation. The average (+/-standard deviation [SD]) number of sessions needed to achieve repigmentation was 16.8 (8.0), whereas the average (+/-SD) number of sessions needed to realize Grade IV repigmentation was 20.2 (15). The type of repigmentation varied between lesions. Diffuse repigmentation was the most common pattern and occurred in 34 lesions (36.6%). Facial lesions responded better than lesions located elsewhere. Skin type did not play a statistically significant role (P=.07) in the lesions response to treatment. All side effects were mild and disappeared shortly after end of treatment sessions. CONCLUSION: The clinical data indicate that the treatment of vitiligo using the 308-nm excimer laser is effective and safe and improves psychosocial quality of life. Lesion location, duration of disease, and treatment duration are factors affecting the clinical and psychological outcome.

Quantification and comparison of psychiatric distress in African patients with albinism and vitiligo: a 5-year prospective study.

BACKGROUND: Vitiligo and albinism are two disorders of pigmentation that make the affected African highly visible and strikingly different from their peers. Both pose considerable management challenges, attract significant stigma and profound impairment of quality of life. OBJECTIVE AND METHODS: To determine and compare psychiatric distress in vitiligo and albinism using the Hospital Anxiety and Depression Scale (HADS). Participants were 87 albinos and 102 vitiligo adult patients seen at an urban tertiary hospital in Nigeria between 2004 and 2009. RESULTS: Prevalence of psycho morbidity was 59% (60/102) in vitiligo compared with 26% (23/87) in the albinos. The mean anxiety score was estimated to be 2.55 points lower for albino patients (95% CI: 1.47 to 3.64), and the mean depression score 2.76 points lower (95% CI: 1.84 to 3.68), after adjustment for age, sex and marital status. However, significant differences were not observed when comparing the vitiligo patients with the subset of albino patients with skin cancer. Older patients had significantly higher anxiety and depression scores. Females had significantly higher anxiety scores (but not depression scores) compared to males. Genital involvement in vitiligo was significantly associated with anxiety but not depression. CONCLUSIONS: We found that the African with vitiligo suffers significantly higher psychiatric distress than the African albino on average. Clinical evaluation of these patients would be incomplete without assessment of their psycho morbidity. There is need for increased focus on cancer prevention strategies in the African albino.