Healthcare Providers’ Perspectives on Nonsegmental Vitiligo Severity, Patient Impact, and Treatment Gaps in the United States and Europe
Abstract
Background Non-segmental vitiligo (NSV) is a heterogeneous autoimmune disease with wide clinical variability in lesion appearance, location, and disease activity. The impact of vitiligo on the patient is also complex, with clinical, treatment, and inter- and intrapersonal factors shaping the patient’s perception of disease severity. Given the complexity of clinical and patient burden, there remains a critical gap in understanding how healthcare professionals integrate these factors into clinical severity assessments and how such assessments inform treatment and management decisions. Objectives Describe how healthcare providers (HCPs) across six countries assess NSV severity and how it informs treatment and management of NSV. Methods Semi-structured interviews were conducted with 65 HCPs (61 dermatologists and 4 nurse practitioners) in the United States (US) and Europe. The interviews covered classifying disease severity and approaches to treating NSV. Interviews were thematically analyzed using a content analysis. Results HCPs reported variable definitions of vitiligo severity, often relying on patient-reported QOL, extent of lesions, and lesion location, among other factors. Treatment goals consisted of disease stabilization, repigmentation, and improving QOL. Topical corticosteroids and calcineurin inhibitors, systemic steroids, topical JAK inhibitors, and phototherapy are regularly used to treat NSV, but with regional differences. Treatment selection is driven disease progression, extent of lesions, and patient burden. However, HCPs noted challenges with current treatments, including access and adherence barriers, safety risks, and a lack of long-term options with durable response. Definitions of treatment success and failure varied across regions, but included repigmentation and positive impact on QOL. Conclusions The heterogeneity of NSV shapes HCP assessments of disease severity, treatment decision-making, and evaluations of treatment success. In the absence of standardized disease severity criteria, definitions varied across countries. Although existing treatments can be effective, barriers related to safety, access, and durability limit long-term use. Across countries, HCPs emphasized QOL impacts as central to severity assessment, goal setting, and treatment success, underscoring the need for clinical frameworks that integrate the patient experience and shared decision-making in all aspects of NSV care.
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BibTeX
@misc{kurosky2026healthcare,
title = {{Healthcare Providers’ Perspectives on Nonsegmental Vitiligo Severity, Patient Impact, and Treatment Gaps in the United States and Europe}},
author = {Samantha K Kurosky and Roni Adiri and Tatjana Lukic and Mojgan Sadrarhami and Alexandra Kissling and Gabriela Burgos and Jennifer O'Brien and Iltefat Hamzavi and Richard H Huggins and Viktoria Eleftheriadou and Mauro Picardo and Jose Luis Lopez-Estebaranz and Thierry Passeron and Julien Seneschal and Khaled Ezzedine},
howpublished = {HAL},
year = {2026},
month = aug,
doi = {10.1093/bjd/ljag309},
url = {https://u-bordeaux.hal.science/hal-05743594v1},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Healthcare Providers’ Perspectives on Nonsegmental Vitiligo Severity, Patient Impact, and Treatment Gaps in the United States and Europe
AU - Samantha K Kurosky
AU - Roni Adiri
AU - Tatjana Lukic
AU - Mojgan Sadrarhami
AU - Alexandra Kissling
AU - Gabriela Burgos
AU - Jennifer O'Brien
AU - Iltefat Hamzavi
AU - Richard H Huggins
AU - Viktoria Eleftheriadou
AU - Mauro Picardo
AU - Jose Luis Lopez-Estebaranz
AU - Thierry Passeron
AU - Julien Seneschal
AU - Khaled Ezzedine
PY - 2026
DA - 2026/08/01
PB - HAL
DO - 10.1093/bjd/ljag309
UR - https://u-bordeaux.hal.science/hal-05743594v1
AB - Background Non-segmental vitiligo (NSV) is a heterogeneous autoimmune disease with wide clinical variability in lesion appearance, location, and disease activity. The impact of vitiligo on the patient is also complex, with clinical, treatment, and inter- and intrapersonal factors shaping the patient’s perception of disease severity. Given the complexity of clinical and patient burden, there remains a critical gap in understanding how healthcare professionals integrate these factors into clinical severity assessments and how such assessments inform treatment and management decisions. Objectives Describe how healthcare providers (HCPs) across six countries assess NSV severity and how it informs treatment and management of NSV. Methods Semi-structured interviews were conducted with 65 HCPs (61 dermatologists and 4 nurse practitioners) in the United States (US) and Europe. The interviews covered classifying disease severity and approaches to treating NSV. Interviews were thematically analyzed using a content analysis. Results HCPs reported variable definitions of vitiligo severity, often relying on patient-reported QOL, extent of lesions, and lesion location, among other factors. Treatment goals consisted of disease stabilization, repigmentation, and improving QOL. Topical corticosteroids and calcineurin inhibitors, systemic steroids, topical JAK inhibitors, and phototherapy are regularly used to treat NSV, but with regional differences. Treatment selection is driven disease progression, extent of lesions, and patient burden. However, HCPs noted challenges with current treatments, including access and adherence barriers, safety risks, and a lack of long-term options with durable response. Definitions of treatment success and failure varied across regions, but included repigmentation and positive impact on QOL. Conclusions The heterogeneity of NSV shapes HCP assessments of disease severity, treatment decision-making, and evaluations of treatment success. In the absence of standardized disease severity criteria, definitions varied across countries. Although existing treatments can be effective, barriers related to safety, access, and durability limit long-term use. Across countries, HCPs emphasized QOL impacts as central to severity assessment, goal setting, and treatment success, underscoring the need for clinical frameworks that integrate the patient experience and shared decision-making in all aspects of NSV care.
ER -