Knowledge, habits, and risk perception associated with sun exposure in patients suffering from vitiligo.
Kechichian E, Bhavnit B, Castelneau J, Seite S, Taieb C, Merurant J, Hamzavi I. Knowledge, habits, and risk perception associated with sun exposure in patients suffering from vitiligo.. Journal of the American Academy of Dermatology 2018; 79(3):AB175.
Journal of the American Academy of Dermatology
Introduction: Despite UVs Exposure, whether artificial or natural, being one of the main treatments of vitiligo [V], very little is known on the sun protection habits of patients suffering from V.
Material and methods: Beginning on April 20, 2017, a multicentric, prospective, cross-sectional study has been conducted. Participants were asked to respond to a self-administered questionnaire. Patients were recruited among was initiated among adult patients of the French Vitiligo support group and in patients attending reference centers for vitiligo in France (Bordeaux and Créteil) and the USA (Detroit) and patients suffering from V who spontaneously visited in France (Créteil, Bordeaux). Questionnaires comprised sociodemographic items, clinical items including phototype (light skin (LS), phototypes I, II, and II versus dark skin (DS), phototypes IV, V, and VI), self-perceived severity of vitiligo) and items related to photoprotection behavior.
Results: As of May 31, 2017, a total of 196 patients with V had responded to the questionnaire. There was 61.7% of patients with LS vs. 38.3% with DS:; 78% of these patients were women. The only factor that varied between the LS and DS was the frequency of facial V: 89.2% for LS vs. 98% for DS ( P = .006). In total, 14.8% reported peeling at some point after sun exposure in the last 12 months, with 14.2% reporting sunburn. In terms of risk awareness, 86.7% stated the belief that there is an increased risk of burning on skin affected by V compared with normal skin (90.3% for LS vs. 81.3% for DS ( P = .039)), but no differences were observed in the perception of an increased risk of skin cancer (47.96%). Similarly, 73.53% of LS patients vs. 61.13% of DS patients reported that they avoided sun exposure between 11 am and 5 pm ( P = .03). Finally, 76.8% of LS patients stated that their V prompted them to avoid the sun, compared with 54.6% of DS patients ( P < .001), and 34.18% of all participants reported that they had changed their choice of holiday destination at least once as a result of their V. In terms of sun protection, 91% reported using some form of protection (NS). Sunscreen was the form of protection used by 87.7% of participants (96% of those who had experienced sunburn over the course of the previous year). In addition, 70% of participants applied sunscreen exclusively during periods of intense sun exposure with no significant difference between phototypes.
Discussion: Our preliminary results suggest that experiencing sunburn at some point over the previous year is linked to more strict usage of sun protection in subjects suffering from V. Furthermore, the perception of an increased risk of skin cancer was reported by almost one out of two participants, even though there is now strong epidemiologic and physiopathologic arguments supporting a reduced risk of skin cancer in patients suffering from V, even after adjusting for sun protection usage habits.
Conclusion: Finally, the extent and severity of vitiligo, independently of phototype, is closely linked to more strict photoprotection behavior.