OBJECTIVES: To identify prevalence of patients with vitiligo, characterize them and assess their comorbidities, use of healthcare resources and healthcare integrated costs from the Italian National Health System (INHS) perspective.

METHODS: From the Fondazione ReS (Ricerca e Salute) database, patients with vitiligo (in-hospital diagnosis and phototherapy, excluding subjects with psoriasis, dialysis, lymphoma, atopic dermatitis) were identified on 1 January 2019, and described by sex and age. A case-control analysis was performed with a matching ratio 1:5, according to sex, age and residency, to assess comorbidities (diabetes, inflammatory bowel diseases - IBDs, myasthenia gravis, neoplasia, rheumatoid arthritis, systemic lupus erythematosus, thyroid diseases) until 2013, drugs reimbursed by the INHS, overnight hospitalizations, outpatient specialist care and healthcare integrated costs charged to the INHS within one-year follow-up.

RESULTS: From >5 million inhabitants in the ReS database in 2019, 2,947 patients with vitiligo were identified (prevalence: 0.06%): 54% females; mean age 55±22; median age 54 (35;71). At least one comorbidity was found in 28.8% of cases (vs 19.2% of controls): thyroid disorders, neoplasia, IBDs and rheumatoid arthritis were prevalent among cases (p<0.001). Within one-year follow-up: 80.3% of cases (vs 71.9% of controls) received ≥1 drug (antibacterials for systemic use the most prescribed); 9.6% of cases (vs 4.9% of controls) were hospitalized at least once, mostly due to lung and cardiac disorders; ≥1 outpatient specialist care was provided to 76.8% of cases (vs 63.1% of controls); on average, the INHS spent €1.634 (vs €844) for one patient with vitiligo (vs control), mainly due to drugs and overnight hospitalizations.

CONCLUSIONS: Vitiligo is a highly undetected and untreated disease. Although this study underestimated its prevalence, Italian administrative healthcare data catched the higher concern among women and quantified the burden on the INHS of patients with a diagnosis of vitiligo and treated with phototherapy.