{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T07:44:24Z","timestamp":1785743064542,"version":"3.56.0"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"abstract":"Summary<\/jats:title>\n \n Background and objectives<\/jats:title>\n The financial and time\u2010related burden of patients with vitiligo remains insufficiently studied. This study aimed to quantify out\u2010of\u2010pocket costs (OOPC) and time expenditure for vitiligo management and the associated sociodemographic, clinical, and behavioral factors in German\u2010speaking countries.<\/jats:p>\n <\/jats:sec>\n \n Patients and methods<\/jats:title>\n Adults with self\u2010reported vitiligo were recruited through patient organizations, social media, and dermatology centers and completed a questionnaire assessing OOPC, vitiligo\u2010related time investment, disease severity (SA\u2010VES), quality of life (DLQI), and digital media use. Group comparisons and multivariable linear regression models were used to identify factors influencing OOPC and time expenditure.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 173 participants included, mean annual OOPC was \u20ac704 (SD \u20ac1,284). The most frequently reported expenses were sunscreen (89.6 %), camouflage products (54.3 %), moisturizers (49.7 %), and dietary supplements (48.0 %). Higher OOPC was associated with higher DLQI scores (\n p<\/jats:italic>\n \u00a0<\u00a00.001) and digital media use for alternative treatments (\n p<\/jats:italic>\n \u00a0=\u00a00.002). Mean daily time on disease\u2010related care was 15.8\u00a0minutes (SD 20.9), independently associated with higher DLQI (\n p<\/jats:italic>\n \u00a0<\u00a00.001), female sex (\n p<\/jats:italic>\n \u00a0<\u00a00.001), higher education (\n p<\/jats:italic>\n \u00a0=\u00a00.006), and vitiligo\u2010related Instagram use (\n p<\/jats:italic>\n \u00a0=\u00a00.007).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Vitiligo imposes a substantial financial and time burden, both of which are closely associated with impaired quality of life, underscoring the importance of routine DLQI assessment.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ddg.70388","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T06:47:03Z","timestamp":1785739623000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Out\u2010of\u2010pocket costs and time spent on disease management by vitiligo patients: a cross\u2010sectional questionnaire study in German\u2010speaking countries"],"prefix":"10.1111","author":[{"given":"Christine","family":"Gasteiger","sequence":"first","affiliation":[{"name":"Technical University of Munich TUM School of Medicine and Health Department of Dermatology and Allergy Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2856-8645","authenticated-orcid":false,"given":"Michael","family":"Hindelang","sequence":"additional","affiliation":[{"name":"Technical University of Munich TUM School of Medicine and Health Department of Dermatology and Allergy Munich Germany"},{"name":"Pettenkofer School of Public Health Munich Germany"},{"name":"Institute for Medical Information Processing Biometry and Epidemiology \u2013 IBE LMU Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3176-1120","authenticated-orcid":false,"given":"Stefanie","family":"Ziehfreund","sequence":"additional","affiliation":[{"name":"Technical University of Munich TUM School of Medicine and Health Department of Dermatology and Allergy Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4097-4518","authenticated-orcid":false,"given":"Hannah","family":"Wecker","sequence":"additional","affiliation":[{"name":"Technical University of Munich TUM School of Medicine and Health Department of Dermatology and Allergy Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilo","family":"Biedermann","sequence":"additional","affiliation":[{"name":"Technical University of Munich TUM School of Medicine and Health Department of Dermatology and Allergy Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9313-6588","authenticated-orcid":false,"given":"Alexander","family":"Zink","sequence":"additional","affiliation":[{"name":"Technical University of Munich TUM School of Medicine and Health Department of Dermatology and Allergy Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0163806"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2015.56.3.719"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.15743"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000506103"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.13215"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2118828"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2023.2787"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-021-00631-6"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.17998"},{"issue":"10","key":"e_1_2_8_11_1","first-page":"1135","article-title":"Social Media Platforms as a Resource for Vitiligo Support","volume":"21","author":"Boothby\u2010Shoemaker W","year":"2022","journal-title":"J. Drugs. Dermatol."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2009.09091.x"},{"issue":"5","key":"e_1_2_8_13_1","doi-asserted-by":"crossref","DOI":"10.1111\/dth.12620","article-title":"Patient\u2010reported outcomes: A 5\u2010year long study reveals previously unreported therapeutic, demographic, socio\u2010economic, and other correlations in vitiligo","volume":"31","author":"Valle Y","year":"2018","journal-title":"Dermatol. Ther."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2340\/actadv.v103.4441"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17000"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15856"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2021.03.016"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.09.034"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1994.tb01167.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000313825"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0736-8046.2004.21601.x"},{"issue":"3","key":"e_1_2_8_22_1","first-page":"119","article-title":"Time spent on treatment (TSOT). An independent assessment of disease severity in atopic dermatitis","volume":"15","author":"Jemec GBE","year":"2006","journal-title":"Acta. Dermatovenerol. Alp. Pannonica. Adriat."},{"issue":"1","key":"e_1_2_8_23_1","first-page":"7","article-title":"Sun\u2010protection habits and knowledge of patients with vitiligo","volume":"29","author":"Baykal Sel\u00e7uk L","year":"2020","journal-title":"Acta. Dermatovenerol. Alp. Pannonica. Adriat."},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.12799"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.07.050"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.11124\/jbisrir-2010-159"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.13459"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15581"},{"issue":"8","key":"e_1_2_8_29_1","article-title":"Diet and Vitiligo: The Story So Far","volume":"14","author":"Dutta RR","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.14436"},{"issue":"2","key":"e_1_2_8_31_1","doi-asserted-by":"crossref","first-page":"152","DOI":"10.2340\/00015555-1037","article-title":"Significant immediate and long\u2010term improvement in quality of life and disease coping in patients with vitiligo after group climatotherapy at the Dead Sea","volume":"91","author":"Kr\u00fcger C","year":"2011","journal-title":"Acta. Derm. Venereol."},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2010.03903.x"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2010.03600.x"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-015-0076-3"},{"key":"e_1_2_8_35_1","unstructured":"World Health Organization.Validity and comparability of out\u2010of\u2010pocket health expenditure from household surveys: a review of the literature and current survey instruments. Available from:https:\/\/apps.who.int\/iris\/handle\/10665\/85711(Last accessed April 1 2026)."}],"container-title":["JDDG: Journal der Deutschen Dermatologischen Gesellschaft"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ddg.70388","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ddg.70388","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ddg.70388","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T06:47:06Z","timestamp":1785739626000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ddg.70388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,2]]},"references-count":34,"alternative-id":["10.1111\/ddg.70388"],"URL":"https:\/\/doi.org\/10.1111\/ddg.70388","archive":["Portico"],"relation":{},"ISSN":["1610-0379","1610-0387"],"issn-type":[{"value":"1610-0379","type":"print"},{"value":"1610-0387","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,2]]},"assertion":[{"value":"2025-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ddg.70388"}}