A review of the vitiligo literature to standardize the expression of disease severity.

This article reviews the existing vitiligo literature to address the lack of standardization in reporting disease severity and treatment outcomes. It summarizes findings from 51 clinical trials involving topical corticosteroids or tacrolimus, highlighting varied grading systems based on body surface area (BSA), photographic assessment, and repigmentation thresholds commonly set at 50%, 75%, and 90%. Validated tools like the Vitiligo Area Scoring Index (VASI) and patient-reported measures such as satisfaction and noticeability scales are discussed, though quality of life has not been clearly correlated with clinical response to topical treatments. The review emphasizes that incorporating categories for no improvement, complete clearance, spontaneous improvement, and worsening, alongside photographic or computer-assisted BSA monitoring, may improve consistency and reproducibility in vitiligo severity reporting.