Abstract Background

Facial involvement of vitiligo is an important factor in patient’s life and has often been evaluated separately from body surface area in clinical trials. However, no reliable measurement tools to measure facial vitiligo specifically are available thus far.

Objective

To develop and validate a practical instrument for assessing facial vitiligo

Methods

The ratios of a hand to a fingertip unit (FTU) of 98 healthy volunteers (age range: 2-69 years) were calculated to define the FTU. Facial Vitiligo Area Scoring Index (F–VASI) was measured as the sum of all FTUs of each vitiligo lesion on the face (range: 0-112 FTU). In the validation study, 6 raters evaluated 11 patients with facial vitiligo twice at an interval of 2 weeks.

Results

One hand was measured at 32.1±1.3 FTU, and it was highly consistent among subjects across different age groups, genders, and races. F−VASI showed remarkably high accuracy (concordance correlation coefficient: 0.946, smallest detectable change: 2.2 FTU) as well as high intra-rater reliability (intraclass correlation coefficient: 0.903) and inter-rater reliability (0.903).

Limitations

Lack of dynamic validation of responsiveness

Conclusion

F−VASI using the FTU is an intuitive, precise, and reliable instrument for assessing the extent of facial involvement in vitiligo patients.

Article InfoPublication History

Accepted: June 25, 2021

Received in revised form: June 10, 2021

Received: November 8, 2019

Publication stageIn Press Journal Pre-ProofFootnotes

Funding: None.

Conflict of Interest: Dr. Hamzavi is an investigator for Incyte, Bayer, Estee Lauder, Unigen, and Ferndale Healthcare. Dr. Lim is an investigator for Incyte, Estee Lauder, Unigen, and Ferndale Healthcare. Dr. Kohli is a sub-investigator for Bayer, Estee Lauder, Unigen, and Ferndale Healthcare. Dr. Lyons is a sub-investigator for Incyte, Bayer, Estee Lauder, and Unigen. Dr. Bae is an investigator for Pfizer and GSK. Dr. Zubair, Dr. Han, Dr. Ju, Dr. Eun, Ms. Lee, and Mr. Vellaichamy have no conflicts to disclose.

IRB approval status: The protocol was approved by the institutional review boards of St. Vincent’s Hospital (VC18RESI0274) and Henry Ford Hospital (IRB No: 11728).

Capsule Summary

● F–VASI using the FTU can be used to reliably and easily assess the extent of vitiligo facial involvement.

● F–VASI using the FTU can be used to not only improve patient care in clinical practice but also to enhance the quality of clinical research.

Identification

DOI: https://doi.org/10.1016/j.jaad.2021.06.880

Copyright

© 2021 Published by Elsevier on behalf of the American Academy of Dermatology, Inc.

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