{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:23:51Z","timestamp":1781871831368,"version":"3.54.5"},"reference-count":19,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Derm Venereol"],"abstract":"<jats:p>Vitiligo is a chronic autoimmune disease that profoundly affects patients\u2019 quality of life. A cross--sectional, observational study was conducted with 51 patients using self-administered questionnaires, with the aim to evaluate the impact of vitiligo on major life-changing decisions (MLCDs) as well as on stigmatization using a modified version of the Patient Unique Stigmatization Holistic tool in dermatology (PUSH-D) scale. Results showed that the most affected MLCDs were clothing choices, social interactions, and lifestyle changes. Facial vitiligo was significantly associated with a greater impact on work-related decisions. Factors such as being single, not having children, being female, and longer disease duration were linked to higher impact on life decisions. The study emphasizes the importance of addressing both clinical severity and the psychological burden of vitiligo to improve patient care.<\/jats:p>","DOI":"10.2340\/actadv.v105.44198","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T10:50:36Z","timestamp":1754391036000},"page":"adv44198","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Vitiligo on Major Life-changing Decisions and Perceived Stigmatization: A Cross-sectional Study"],"prefix":"10.2340","volume":"105","author":[{"given":"Luc\u00eda","family":"Castellano-Lopezosa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Ure\u00f1a Paniego","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sof\u00eda","family":"Haselgruber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Blasco-Morente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"Arias-Santiago","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"120004","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Bootello J, Cova-Mart\u00edn R, Naharro-Rodr\u00edguez J, Segurado-Miravalles G. Vitiligo: pathogenesis and new and emerging treatments. Int J Mol Sci 2023; 24: 17306.","DOI":"10.3390\/ijms242417306"},{"key":"120005","doi-asserted-by":"crossref","unstructured":"Kang C. Ruxolitinib cream 1.5%: a review in non-segmental vitiligo. Drugs 2024; 84: 579\u2013586.","DOI":"10.1007\/s40265-024-02027-2"},{"key":"120006","doi-asserted-by":"crossref","unstructured":"Eleftheriadou V, Ahmed A, Nesnas J, Nagra R. The lifetime risk and impact of vitiligo across sociodemographic groups: a UK population-based cohort study. Br J Dermatol 2024; 192: 63\u201371.","DOI":"10.1093\/bjd\/ljae282"},{"key":"120007","doi-asserted-by":"crossref","unstructured":"Rosmarin D, Soliman AM, Piercy J, Marwaha S, Anderson P, Camp HS. Health-related quality-of-life burden among adults with vitiligo: relationship to disease severity and disease location. Dermatol Ther (Heidelb) 2024; 14: 1633\u20131647.","DOI":"10.1007\/s13555-024-01187-z"},{"key":"120008","doi-asserted-by":"crossref","unstructured":"Seneschal J. Clinical features of vitiligo and social impact on quality of life. Dermatol Pract Concept 2023; 13: e2023312S.","DOI":"10.5826\/dpc.1304S2a312S"},{"key":"120009","doi-asserted-by":"crossref","unstructured":"Ezzedine K, Shourick J, Bergqvist C, Misery L, Chuberre B, Kerob D, et al. Patient Unique Stigmatization Holistic tool in dermatology (PUSH-D): development and validation of a dermatology-specific stigmatization assessment tool. J Eur Acad Dermatol Venereol 2023; 37: 443\u2013450.","DOI":"10.1111\/jdv.18641"},{"key":"120010","doi-asserted-by":"crossref","unstructured":"Bhatti ZU, Salek S, Finlay AY. Concept of major life-changing decisions in life course research. Curr Probl Dermatol 2013; 44: 52\u201366.","DOI":"10.1159\/000350389"},{"key":"120011","doi-asserted-by":"crossref","unstructured":"Komen L, da Gra\u00e7a V, Wolkerstorfer A, de Rie MA, Terwee CB, van der Veen JPW. Vitiligo Area Scoring Index and Vitiligo European Task Force assessment: reliable and responsive instruments to measure the degree of depigmentation in vitiligo. Br J Dermatol 2015; 172: 437\u2013443.","DOI":"10.1111\/bjd.13432"},{"key":"120012","doi-asserted-by":"crossref","unstructured":"Komen L, van der Kraaij GE, van der Veen JPW, de Rie MA, Wolkerstorfer A. The validity, reliability and acceptability of the SAVASI: a new self-assessment score in vitiligo. J Eur Acad Dermatol Venereol 2015; 29: 2145\u20132151.","DOI":"10.1111\/jdv.13161"},{"key":"120013","doi-asserted-by":"crossref","unstructured":"Ezzedine K, Eleftheriadou V, Jones H, Bibeau K, Kuo FI, Sturm D, et al. Psychosocial effects of vitiligo: a systematic literature review. Am J Clin Dermatol 2021; 22: 757\u2013774.","DOI":"10.1007\/s40257-021-00631-6"},{"key":"120014","doi-asserted-by":"crossref","unstructured":"Bibeau K, Ezzedine K, Harris JE, van Geel N, Grimes P, Parsad D, et al. Mental health and psychosocial quality-of-life burden among patients with vitiligo: findings from the Global VALIANT study. JAMA Dermatol 2023; 159: 1124\u20131128.","DOI":"10.1001\/jamadermatol.2023.2787"},{"key":"120015","doi-asserted-by":"crossref","unstructured":"Silveira LP, Grijsen ML, Follador I, Dellatorre G. How persistent stigma and discrimination keep people with visible skin diseases out of jobs: vitiligo in Brazil today. Lancet Reg Health Am 2023; 23: 100524.","DOI":"10.1016\/j.lana.2023.100524"},{"key":"120016","doi-asserted-by":"crossref","unstructured":"Zahra M, Zubair A, Aslam N, Naz M. Investigating the impact of perceived social stigmatization and social appearance anxiety on quality of life among patients with facial skin diseases. Arch Dermatol Res 2025; 317: 198.","DOI":"10.1007\/s00403-024-03719-1"},{"key":"120017","doi-asserted-by":"crossref","unstructured":"Ning X, Zhang Y, Wang W, Yan H. The association between social support and depression among patients with vitiligo in China. Front Psychol 2022; 13: 939845.","DOI":"10.3389\/fpsyg.2022.939845"},{"key":"120018","doi-asserted-by":"crossref","unstructured":"Sampogna F, Samela T, Abeni D, Schut C, Kupfer J, Bewley AP, et al. A cross-sectional study on gender differences in body dysmorphic concerns in patients with skin conditions in relation to sociodemographic, clinical and psychological variables. J Eur Acad Dermatol Venereol 2025; 39: 823\u2013832.","DOI":"10.1111\/jdv.20247"},{"key":"120019","doi-asserted-by":"crossref","unstructured":"Fakih A, Tannous R, Lajnef M, Seneschal J, Andreu N, Tran VT, et al. Stigma in vitiligo: associated factors and severity strata of the Patient Unique Stigmatization Holistic tool in Dermatology (PUSH-D) score. Br J Dermatol 2024; 190: 712\u2013717.","DOI":"10.1093\/bjd\/ljae020"},{"key":"120020","doi-asserted-by":"crossref","unstructured":"Paller AS, Rangel SM, Chamlin SL, Hajek A, Phan S, Hogeling M, et al. Stigmatization and mental health impact of chronic pediatric skin disorders. JAMA Dermatol 2024; 160: 621\u2013630.","DOI":"10.1001\/jamadermatol.2024.0594"},{"key":"120021","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-D\u00edaz M, D\u00edaz-Calvillo P, Soto-Moreno A, Molina-Leyva A, Arias-Santiago S. Factors influencing major life-changing decisions in patients with psoriasis: a cross-sectional study. Acta Derm Venereol 2023; 103: adv11640.","DOI":"10.2340\/actadv.v103.11640"},{"key":"120022","doi-asserted-by":"crossref","unstructured":"Fuentes-Barrag\u00e1n L, Garc\u00eda-Moronta C, Sanabria-de la Torre R, Le\u00f3n-P\u00e9rez FJ, Molina-Leyva A, Arias-Santiago S, et al. Impact on major life-changing decisions in patients with atopic dermatitis. 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