Investigation On The Cognitive And Management Needs Of Home Phototherapy In Patients With Vitiligo

BackgroundVitiligo is an acquired pigmentary disorder that is characterized by white skin and/or white hair caused by damage or loss of epidermal melanocytes.The incidence rate of this disease is about 0.5-2%worldwide.This disease has a certain degree of damage to appearance,and timely diagnosis and active treatment are crucial for controlling the development of the disease and promoting repigmentation.At present,clinical treatment mainly induces the proliferation and differentiation of melanocyte stem cells around hair follicles or skin lesions through drugs,physical therapy,or surgery,and then re-migrates into the skin lesions to achieve repigmentation.Phototherapy has become a first-line treatment for vitiligo due to its good efficacy and safety.As an alternative to in-hospital phototherapy,home-based phototherapy(HBPT)aims to ensure treatment efficacy while improving the cost-effectiveness of phototherapy and providing patients with personalized treatment choices.However,due to the lack of professional knowledge and professional guidance from doctors,there are certain safety issues in the implementation of HBPT.Therefore,it is necessary to investigate this issue,understand the actual situation of patients during the operation process,and provide targeted guidance to truly give full play to the advantages of home-based phototherapy.Objective1.Analyze the epidemiological characteristics of vitiligo patients,understand the characteristics of the disease and the clinical application and feedback of existing treatment.2.Investigate the knowledge dissemination and usage of home-based phototherapy in vitiligo patients,evaluate the efficacy,safety and compliance of home-based phototherapy in the treatment of vitiligo,and summarize the patient management needs of home-based phototherapy.Methods1.Retrospectively analyze the clinical data of vitiligo patients who visited the outpatient department of the Chinese Academy of Medical Sciences Dermatology Hospital from December 2021 to September 2022.For patients clinically diagnosed with vitiligo,investigate their basic situation,etiology and pathogenesis,clinical staging and classification,and onset situation through questionnaires,and statistically analyze the clinical and epidemiological characteristics involved.2.From October 2022 to November 2022,a network questionnaire survey was conducted on the use of home-based phototherapy by vitiligo patients through our hospital’s outpatient department and media platforms.Investigate the use of home-based phototherapy and patient management needs for vitiligo patients who have been diagnosed and treated with HBPT equipment;screen out unqualified questionnaires,use Excel tables for data entry and collation,and use SPSS23.0 statistical software for final data statistical description and analysis.ResultsA total of 496 qualified questionnaires were collected,including 241 males and 255 females,with a male-to-female ratio of 1:1.05,and no significant difference in the incidence rate between males and females.The average age of onset was 23.91± 12.88 years old,mainly in adolescence.There were 71 cases(14.3%)with a positive family history,among which the highest incidence rate was shared by first-degree relatives,accounting for 35.2%.The average age of onset for those with a positive family history(19.25±11.24 years old)was significantly lower than that for those with a negative family history(24.68±12.98 years old),and the difference was statistically significant(t=2.16,p<0.05).There were 287 cases(57.6%)of non-segmental type,108 cases(21.9%)of segmental type,33 cases(6.7%)of mixed type,and 68 cases(13.7%)of undetermined type.A total of 60 patients(12.1%)had combined autoimmune diseases(including thyroid diseases,diabetes,rheumatic diseases,and alopecia areata).The overall awareness level of home-based phototherapy among the population surveyed in this study was relatively high,with 422 patients(85.1%)having some understanding of HBPT,mainly obtained through visiting doctors(262/422,62.2%).Among them,342 patients(68.9%)were willing to use HBPT,mainly to save time spent on medical visits and reduce absenteeism from work or school(209/342,61.0%).A total of 78 patients(15.7%)refused to use HBPT mainly due to the high cost of equipment(45/78,57.2%).The guidance information that patients most wanted to receive was the adjustment method for phototherapy dosage and course duration(184/352,52.3%),as well as an assessment of whether they were suitable for home-based phototherapy(160/352,45.5%).The most effective way to obtain health education information was through verbal education by medical staff(177/352,50.3%).Conclusion1.Vitiligo has no significant gender difference in onset,and adolescents and young adults are the high-risk population.In some cases,it can occur at birth.The most commonly affected areas are the exposed parts of the head,face,neck,hands and feet.Some patients have obvious inducements before the onset of the disease,with mental stress and sun exposure being more common.Vitiligo is often associated with other autoimmune diseases such as thyroid disease and alopecia areata.2.The onset of vitiligo has genetic susceptibility,with a higher incidence rate among first-degree relatives than second-and third-degree relatives.The average age of onset for those with a positive family history is significantly lower than that for those with a negative family history.3.Patients with vitiligo have a considerable understanding of and willingness to use HBPT.The guidance information that patients most want to receive is the adjustment method for phototherapy dosage and course duration,an assessment of whether they are suitable for home-based phototherapy,and information on how to deal with adverse reactions.The most effective way to obtain health education information is through verbal education by medical staff.